[Active tobacco smoking as determinant of costs of inpatient treatment of COPD exacerbations].

The aim of the study was assessment of the influence of tobacco smoking on direct costs of in-hospital treatment of chronic obstructive pulmonary disease exacerbations (COPD). 112 men who underwent in-hospital treatment of exacerbation of moderate COPD in the years 2001-2002 were included in the study. The patients were qualified into one of three groups: I--never-smoking patients (n=40); II--former smokers (n=42); III--active smokers (n=30). The mean age of patients was 70.9 +/- 8.9 years (I--74.8 +/- 7.4; II--68.4 +/- 9.4; III--69.4 +/- 9.8). The mean direct cost of COPD patient treatment was PLN 2162.00 +/- 920.90 (I--PLN 2025.50 +/- 681.30; II--PLN 1875.80 +/- 608.70; III--PLN 2744.60 +/- 1266.20). The mean period of smoking was 18.3 pack-years in the group II and 27.7 pack-years in the group III. No significant differences in FEV1 were found between the groups. No significant differences were found in the treatment costs between the groups I and II. It was demonstrated that the costs of in-hospital COPD treatment are significantly higher in the group III than in the groups I and II. A linear regression formula was calculated, showing a linear relationship between each consecutive pack-year of addiction and the costs of exacerbation treatment in the group III (R=0.39, R2=0.13, standardized BETA index = 24.0; p<0.03). No similar relationship was found in the former smokers' group. The analysis of the data shows that: (1) active tobacco smoking by patients is related to significantly higher direct costs of in-hospital treatment of COPD exacerbations than in case of never-smoking patients or patients who smoked in the past, and (2) the costs of in-hospital treatment of COPD exacerbations in case of people who have stopped smoking are comparable to the costs of hospitalization of never-smoking patients with COPD.