Shah Chintal H, Onukwugha Eberechukwu, Zafari Zafar, Villalonga-Olives Ester, Park Jeong-Eun, Slejko Julia F
Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD, USA.
Expert Rev Pharmacoecon Outcomes Res. 2022 Jun;22(4):683-690. doi: 10.1080/14737167.2021.1981291. Epub 2021 Sep 24.
This study quantifies costs associated with comorbid conditions among adults diagnosed with chronic obstructive pulmonary disease (COPD) who experience acute exacerbations (AECOPD) needing inpatient hospitalization.
This retrospective cohort study used 2006-2015 IQVIA PharMetrics® Plus data, a health plan claims database. Patients aged 40-64 years, with AECOPD, defined as an inpatient hospitalization for a COPD-related diagnosis were included. The impact of comorbidities on AECOPD costs (costs of the COPD-related inpatient stay plus healthcare services used 30 days post-discharge) was determined using multivariable regression. The models adjusted for clinical complications, previous utilization, age, sex, region, year, length of hospitalization, and season of admission.
Among these COPD patients, 89.5% had at least 1 comorbidity. The mean cost for AECOPD was 2015 US $19,687 (SD: 27,035, median: 11,539). Congestive heart failure, lipid disorders, cancer, and presence of any of the 10 most frequent comorbidities were associated with $1,921 (95% confidence interval (CI): 977-2,866), $1,619 (95% CI: 967-2,272), $8,347 (95% CI: 7,236-9,458), and $4,433 (95% CI: 3,598-5,268) higher costs, respectively than corresponding individuals without these comorbid conditions. Patients with depressive disorders were associated with $1,592 (95% CI: 828-2,355) lower costs compared to those without depressive disorders.
COPD comorbidity imposes a significant economic burden on AECOPD.
本研究对被诊断为慢性阻塞性肺疾病（COPD）且经历了需要住院治疗的急性加重期（AECOPD）的成年人中与共病相关的费用进行了量化。
这项回顾性队列研究使用了2006 - 2015年IQVIA PharMetrics® Plus数据，这是一个健康保险理赔数据库。纳入年龄在40 - 64岁、患有AECOPD（定义为因COPD相关诊断而住院治疗）的患者。使用多变量回归确定共病对AECOPD费用（COPD相关住院费用加上出院后30天内使用的医疗服务费用）的影响。模型对临床并发症、既往利用率、年龄、性别、地区、年份、住院时长和入院季节进行了调整。
在这些COPD患者中，89.5%至少有一种共病。AECOPD的平均费用在2015年为19,687美元（标准差：27,035，中位数：11,539）。充血性心力衰竭、脂质紊乱、癌症以及10种最常见共病中的任何一种，与无这些共病的相应个体相比，费用分别高出1,921美元（95%置信区间（CI）：977 - 2,866）、1,619美元（95% CI：967 - 2,272）、8,347美元（95% CI：7,236 - 9,458）和4,433美元（95% CI：3,598 - 5,268）。与无抑郁症的患者相比，患有抑郁症的患者费用低1,592美元（95% CI：828 - 2,355）。
COPD共病给AECOPD带来了巨大的经济负担。
