Moretti Anna Maria, Tafuri Silvio, Parisi Davide, Germinario Cinzia
Pneumology Department, Policlinico General Hospital, Bari, Italy.
Multidiscip Respir Med. 2011 Oct 31;6(5):299-304. doi: 10.1186/2049-6958-6-5-299.
Chronic obstructive pulmonary disease (COPD) is currently the 5th cause of morbidity and mortality in the developed world and represents a substantial economic and social burden. The aim of this study is to report on hospital admissions and related costs of hospital treatment for COPD in the Puglia Region of Italy in the years 2005-2007.
Patients were selected who were hospitalized between 01/01/2005 and 31/12/2007 with ICD-9-CM code: 490.xx: bronchitis not specified as acute or chronic; 491.xx: chronic bronchitis; 492.xx: emphysema; 493.xx: asthma; 494.xx: bronchiectasis; 496.xx: chronic airway obstruction not elsewhere classified; 518.81: acute respiratory failure as principal or secondary diagnosis.
In the period 2005-2007, there were 73,721 hospital admissions for COPD registered in Puglia (25,690 in 2005; 24,153 in 2006 and 23,878 in 2007) of which 34.3% were women, with no significant variation in the three years. There appears to be a negative trend in hospitalisations in Puglia for chronic bronchitis with ratios decreasing from 359.4 per 100,000 population in 2005 to 307.9 per 100,000 in 2007. The overall cost of COPD for Apulian hospital trusts was €272,293,182.85 over the 3-year period.
Analysis of the data for hospital care, its costs and performance may be an important indicator of the efficacy of community care. In particular, the lack of reduction in admissions for COPD should lead decision makers to question both the appropriateness and quality of the care given.
慢性阻塞性肺疾病（COPD）目前是发达国家发病和死亡的第五大原因，带来了巨大的经济和社会负担。本研究旨在报告2005 - 2007年意大利普利亚地区因COPD住院治疗的情况及相关费用。
选取2005年1月1日至2007年12月31日期间住院的患者，其国际疾病分类第九版临床修订本（ICD - 9 - CM）编码为：490.xx：未明确为急性或慢性的支气管炎；491.xx：慢性支气管炎；492.xx：肺气肿；493.xx：哮喘；494.xx：支气管扩张；496.xx：未在其他处分类的慢性气道阻塞；518.81：作为主要或次要诊断的急性呼吸衰竭。
在2005 - 2007年期间普利亚地区登记的因COPD住院病例有73,721例（2005年为25,690例；2006年为24,153例；2007年为23,878例），其中34.3%为女性，三年间无显著变化。普利亚地区慢性支气管炎的住院率呈下降趋势，比例从2005年的每10万人口359.4例降至2007年的每10万人口307.9例。在这三年期间，普利亚地区医院信托机构治疗COPD的总费用为272,293,182.85欧元。
对医院护理数据、其成本和绩效的分析可能是社区护理效果的重要指标。特别是，COPD住院人数没有减少，这应促使决策者质疑所提供护理的适当性和质量。
