Jansson Sven-Arne, Backman Helena, Rönmark Eva, Lundbäck Bo, Lindberg Anne
a Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine , The OLIN Unit, Umeå University , SE-901 87 Umeå, Sweden.
COPD. 2015 Aug;12(4):381-9. doi: 10.3109/15412555.2014.974089.
Co-morbidities are common in COPD; however, there is a lack of population-based studies evaluating the health economic impact of co-morbid diseases for subjects with COPD. The main objective of this study was to estimate annual direct health-care costs, divided into costs due to non-respiratory and respiratory conditions, comparing subjects with and without COPD.
Subjects with and without COPD derived from population-based cohorts in northern Sweden have been invited to annual examinations involving spirometry and structured interviews since 2005. This paper is based on data from 1472 subjects examined in 2006. COPD classification was based on spirometry.
Mean annual costs for both respiratory and non-respiratory conditions were significantly higher for subjects with COPD than non-COPD subjects, in total USD 2139 vs. USD 1276 (p = 0.026), and COPD remained significantly associated with higher costs also after adjustment for common confounders as age, smoking habits, BMI and sex. The mean total cost increased with COPD disease severity and was higher for all severity stages (GOLD) than for non-COPD subjects. Hospitalization due to non-respiratory diseases was the main cost driver in COPD, after adjustment for common confounders amounting to about 46% (unadjusted 62%) of the total COPD-costs.
Costs were higher for COPD than non-COPD. In COPD, costs for co-morbid conditions were higher than those for respiratory conditions, and hospitalization due to co-morbid conditions was the main cost driver also when adjusted for common confounders.
合并症在慢性阻塞性肺疾病（COPD）中很常见；然而，缺乏基于人群的研究来评估合并症对COPD患者的健康经济影响。本研究的主要目的是估计年度直接医疗费用，分为非呼吸道疾病和呼吸道疾病导致的费用，比较有和没有COPD的患者。
自2005年以来，来自瑞典北部基于人群队列的有和没有COPD的患者被邀请参加年度检查，包括肺活量测定和结构化访谈。本文基于2006年检查的1472名患者的数据。COPD分类基于肺活量测定。
COPD患者的呼吸道和非呼吸道疾病的年均费用均显著高于非COPD患者，总计2139美元对1276美元（p = 0.026），并且在对年龄、吸烟习惯、体重指数和性别等常见混杂因素进行调整后，COPD与较高费用仍显著相关。总平均费用随COPD疾病严重程度增加，所有严重程度阶段（GOLD）均高于非COPD患者。在对常见混杂因素进行调整后，非呼吸道疾病导致的住院是COPD的主要费用驱动因素，约占COPD总费用的46%（未调整为62%）。
COPD患者的费用高于非COPD患者。在COPD中，合并症的费用高于呼吸道疾病的费用，并且在对常见混杂因素进行调整后，合并症导致的住院也是主要费用驱动因素。
