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Economic Burden of COPD in the Presence of Comorbidities.

Mannino DM, Higuchi K, Yu TC, Zhou H, Li Y, Tian H, Suh K - Chest (2015)

Bottom Line: Our objective was to assess the impact of comorbidities on COPD-associated costs in a large administrative claims dataset.Most patients (52.8%) had one or two comorbidities of interest.The average all-cause total health-care costs from the index date to 360 days after the index date were highest for patients with chronic kidney disease ($41,288) and anemia ($38,870).

View Article: PubMed Central - PubMed

ABSTRACT

Background: The morbidity and mortality associated with COPD exacts a considerable economic burden. Comorbidities in COPD are associated with poor health outcomes and increased costs. Our objective was to assess the impact of comorbidities on COPD-associated costs in a large administrative claims dataset.

Methods: This was a retrospective observational study of data from the Truven Health MarketScan Commercial Claims and Encounters and the MarketScan Medicare Supplemental Databases from January 1, 2009, to September 30, 2012. Resource consumption was measured from the index date (date of first occurrence of non-rule-out COPD diagnosis) to 360 days after the index date. Resource use (all-cause and disease-specific [ie, COPD- or asthma-related] ED visits, hospitalizations, office visits, other outpatient visits, and total length of hospital stay) and health-care costs (all-cause and disease-specific costs for ED visits, hospitalizations, office visits, and other outpatient visits and medical, prescription, and total health-care costs) were assessed. Generalized linear models were used to evaluate the impact of comorbidities on total health-care costs, adjusting for age, sex, geographic location, baseline health-care use, employment status, and index COPD medication.

Results: Among 183,681 patients with COPD, the most common comorbidities were cardiovascular disease (34.8%), diabetes (22.8%), asthma (14.7%), and anemia (14.2%). Most patients (52.8%) had one or two comorbidities of interest. The average all-cause total health-care costs from the index date to 360 days after the index date were highest for patients with chronic kidney disease ($41,288) and anemia ($38,870). The impact on total health-care costs was greatest for anemia ($10,762 more, on average, than a patient with COPD without anemia).

Conclusions: Our analysis demonstrated that high resource use and costs were associated with COPD and multiple comorbidities.

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Related in: MedlinePlus

Patient selection. ICS = inhaled corticosteroid; LABA = long-acting β2-adrenergic agonist; LAMA = long-acting muscarinic antagonist.
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fig01: Patient selection. ICS = inhaled corticosteroid; LABA = long-acting β2-adrenergic agonist; LAMA = long-acting muscarinic antagonist.

Mentions: This analysis included 183,681 patients (Fig 1). Patient characteristics on the index date are summarized in Table 1, and health-care use and costs from the 180 days preceding the index date through the index date are summarized in Table 2. The most common comorbidity was CVD (34.8%), followed by diabetes (22.8%), asthma (14.7%), anemia (14.2%), CKD (9.9%), depression (9.9%), and osteoporosis (6.9%). Most patients (52.8%) had one or two comorbidities of interest. Patients with CKD and anemia experienced the highest incidence of all-cause ED visits leading to hospitalizations (23.2% and 20.4%, respectively) and all-cause hospitalizations (38.0% and 33.8%, respectively). The percentages of all-cause office visits and of all-cause other outpatient visits were generally similar across the various comorbidity groups (all-cause office visits, 93.8%-95.4%; all-cause other outpatient visits, 95.1%-97.7%) and were higher than those for patients with no baseline comorbidities of interest (83.9% and 84.6%, respectively).


Economic Burden of COPD in the Presence of Comorbidities.

Mannino DM, Higuchi K, Yu TC, Zhou H, Li Y, Tian H, Suh K - Chest (2015)

Patient selection. ICS = inhaled corticosteroid; LABA = long-acting β2-adrenergic agonist; LAMA = long-acting muscarinic antagonist.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4493870&req=5

fig01: Patient selection. ICS = inhaled corticosteroid; LABA = long-acting β2-adrenergic agonist; LAMA = long-acting muscarinic antagonist.
Mentions: This analysis included 183,681 patients (Fig 1). Patient characteristics on the index date are summarized in Table 1, and health-care use and costs from the 180 days preceding the index date through the index date are summarized in Table 2. The most common comorbidity was CVD (34.8%), followed by diabetes (22.8%), asthma (14.7%), anemia (14.2%), CKD (9.9%), depression (9.9%), and osteoporosis (6.9%). Most patients (52.8%) had one or two comorbidities of interest. Patients with CKD and anemia experienced the highest incidence of all-cause ED visits leading to hospitalizations (23.2% and 20.4%, respectively) and all-cause hospitalizations (38.0% and 33.8%, respectively). The percentages of all-cause office visits and of all-cause other outpatient visits were generally similar across the various comorbidity groups (all-cause office visits, 93.8%-95.4%; all-cause other outpatient visits, 95.1%-97.7%) and were higher than those for patients with no baseline comorbidities of interest (83.9% and 84.6%, respectively).

Bottom Line: Our objective was to assess the impact of comorbidities on COPD-associated costs in a large administrative claims dataset.Most patients (52.8%) had one or two comorbidities of interest.The average all-cause total health-care costs from the index date to 360 days after the index date were highest for patients with chronic kidney disease ($41,288) and anemia ($38,870).

View Article: PubMed Central - PubMed

ABSTRACT

Background: The morbidity and mortality associated with COPD exacts a considerable economic burden. Comorbidities in COPD are associated with poor health outcomes and increased costs. Our objective was to assess the impact of comorbidities on COPD-associated costs in a large administrative claims dataset.

Methods: This was a retrospective observational study of data from the Truven Health MarketScan Commercial Claims and Encounters and the MarketScan Medicare Supplemental Databases from January 1, 2009, to September 30, 2012. Resource consumption was measured from the index date (date of first occurrence of non-rule-out COPD diagnosis) to 360 days after the index date. Resource use (all-cause and disease-specific [ie, COPD- or asthma-related] ED visits, hospitalizations, office visits, other outpatient visits, and total length of hospital stay) and health-care costs (all-cause and disease-specific costs for ED visits, hospitalizations, office visits, and other outpatient visits and medical, prescription, and total health-care costs) were assessed. Generalized linear models were used to evaluate the impact of comorbidities on total health-care costs, adjusting for age, sex, geographic location, baseline health-care use, employment status, and index COPD medication.

Results: Among 183,681 patients with COPD, the most common comorbidities were cardiovascular disease (34.8%), diabetes (22.8%), asthma (14.7%), and anemia (14.2%). Most patients (52.8%) had one or two comorbidities of interest. The average all-cause total health-care costs from the index date to 360 days after the index date were highest for patients with chronic kidney disease ($41,288) and anemia ($38,870). The impact on total health-care costs was greatest for anemia ($10,762 more, on average, than a patient with COPD without anemia).

Conclusions: Our analysis demonstrated that high resource use and costs were associated with COPD and multiple comorbidities.

Show MeSH
Related in: MedlinePlus