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使用 BODE 指数和合并症预测慢性阻塞性肺疾病的健康利用资源。

Using the BODE Index and Comorbidities to Predict Health Utilization Resources in Chronic Obstructive Pulmonary Disease.

机构信息

Department of Respiratory Therapy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung City, Taiwan.

Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung City, Taiwan.

出版信息

Int J Chron Obstruct Pulmon Dis. 2020 Feb 19;15:389-395. doi: 10.2147/COPD.S234363. eCollection 2020.

Abstract

BACKGROUND AND OBJECTIVE

Chronic Obstructive Pulmonary Disease (COPD) is a common chronic respiratory disease that in the long term may develop into respiratory failure or even cause death and may coexist with other diseases. Over time, it may incur huge medical expenses, resulting in a heavy socio-economy burden. The BODE (Body mass index, airflow Obstruction, Dyspnea, and Exercise capacity) index is a predictor of the number and severity of acute exacerbations of COPD. This study focused on the correlation between the BODE index, comorbidity, and healthcare resource utilization in COPD.

PATIENTS AND METHODS

This is a retrospective study of clinical outcomes of COPD patients with complete BODE index data in our hospital from January 2015 to December 2016. Based on the patients' medical records in our hospital's electronic database from January 1, 2015 to August 31, 2017, we analyzed the correlation between BODE index, Charlson comorbidity index (CCI), and medical resources.

RESULTS

Of the 396 patients with COPD who met the inclusion criteria, 382 (96.5%) were male, with an average age of 71.3 ± 8.4 years. Healthcare resource utilization was positively correlated with the BODE index during the 32 months of retrospective clinical outcomes. The study found a significant association between the BODE index and the CCI of COPD patients ( < 0.001). In-hospitalization expenses were positively correlated with CCI ( < 0.001). Under the same CCI, the higher the quartile, the higher the hospitalization expenses. BODE quartiles were positively correlated with number of hospitalizations ( < 0.001), hospitalization days ( < 0.001), hospitalization expenses ( = 0.005), and total medical expenses ( = 0.024).

CONCLUSION

This study demonstrates the value of examining the BODE index and comorbidities that can predict healthcare resource utilization in COPD.

摘要

背景与目的

慢性阻塞性肺疾病(COPD)是一种常见的慢性呼吸系统疾病,长期发展可能导致呼吸衰竭甚至死亡,并且可能与其他疾病共存。随着时间的推移,它可能会产生巨大的医疗费用,给社会经济带来沉重负担。BODE(体重指数、气流阻塞、呼吸困难和运动能力)指数是预测 COPD 急性加重次数和严重程度的指标。本研究重点探讨了 BODE 指数、合并症与 COPD 患者医疗资源利用之间的相关性。

患者与方法

这是一项回顾性研究,纳入了我院 2015 年 1 月至 2016 年 12 月期间完整 BODE 指数数据的 COPD 患者。基于我院电子数据库中 2015 年 1 月 1 日至 2017 年 8 月 31 日的患者病历,我们分析了 BODE 指数、Charlson 合并症指数(CCI)与医疗资源之间的相关性。

结果

符合纳入标准的 396 例 COPD 患者中,382 例(96.5%)为男性,平均年龄为 71.3±8.4 岁。在回顾性临床结局的 32 个月中,医疗资源的利用与 BODE 指数呈正相关。研究发现,BODE 指数与 COPD 患者的 CCI 之间存在显著关联(<0.001)。住院费用与 CCI 呈正相关(<0.001)。在相同的 CCI 下,四分位越高,住院费用越高。BODE 四分位与住院次数(<0.001)、住院天数(<0.001)、住院费用(=0.005)和总医疗费用(=0.024)呈正相关。

结论

本研究表明,检查 BODE 指数和合并症对于预测 COPD 患者的医疗资源利用具有重要价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/831d/7036670/976a95be5ce2/COPD-15-389-g0007.jpg

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