Department of Public Health, Research Unit of General Practice, University of Southern Denmark, JB Winsløws vej 9A, 5000, Odense, Denmark.
BMC Health Serv Res. 2022 Mar 28;22(1):408. doi: 10.1186/s12913-022-07778-w.
Many patients with chronic obstructive pulmonary disease (COPD) are treated in general practice only and have never received specialist care for COPD. They are seldom included in COPD cost studies but may account for a substantial proportion of the total costs.
To estimate and specify the total healthcare costs of patients who are treated for COPD in Denmark comparing those who have- and have not had specialist care for COPD.
Denmark, population 5.7 million citizens.
Via national registers, we specified the total healthcare costs of all + 30-years-old current users of respiratory pharmaceuticals. We identified the patients with COPD and compared those with at least one episode of pulmonary specialist care to those with GP care only.
Among totally 329,428 users of respiratory drugs, we identified 46,084 with specialist-care- and 68,471 with GP-care-only COPD. GP-care-only accounted for 40% of the two populations' total healthcare costs. The age- and gender-adjusted coefficient relating the individual total costs specialist-care versus GP-care-only was 2.19. The individual costs ranged widely and overlapped considerably (p25-75: specialist-care €2,175-€12,625, GP-care-only €1,110-€4,350). Hospital treatment accounted for most of the total cost (specialist-care 78%, GP-care-only 62%; coefficient 2.81), pharmaceuticals (specialist-care 16%, GP-care-only 27%; coefficient 1.28), and primary care costs (specialist-care 6%, GP-care-only 11%; coefficient 1.13). The total costs of primary care pulmonary specialists were negligible.
Healthcare policy makers should consider the substantial volume of patients who are treated for COPD in general practice only and do not appear in specialist statistics.
许多慢性阻塞性肺疾病（COPD）患者仅在全科医生处接受治疗，从未接受过 COPD 的专科治疗。他们很少被纳入 COPD 成本研究，但可能占总费用的很大一部分。
在丹麦，通过比较接受和未接受 COPD 专科治疗的患者，估计和明确接受 COPD 治疗的患者的总医疗保健费用。
丹麦，拥有 570 万公民。
通过国家登记册，我们确定了所有使用呼吸药物的年龄在+30 岁以上的当前患者的总医疗保健费用。我们确定了 COPD 患者，并将那些至少有一次肺科专家治疗的患者与仅接受全科医生治疗的患者进行了比较。
在总共 329428 名使用呼吸药物的患者中，我们确定了 46084 名有专科护理的患者和 68471 名仅接受全科医生护理的患者。全科医生护理仅占这两个人群总医疗保健费用的 40%。与全科医生护理相比，个体总费用的个体相关系数为专科护理 2.19。个体费用差异很大且重叠很大（p25-75：专科护理为 2175-12625 欧元，全科医生护理为 1110-4350 欧元）。住院治疗占总费用的大部分（专科护理 78%，全科医生护理 62%；系数 2.81），药物（专科护理 16%，全科医生护理 27%；系数 1.28）和初级保健费用（专科护理 6%，全科医生护理 11%；系数 1.13）。初级保健肺科专家的总费用可忽略不计。
医疗保健政策制定者应考虑到大量仅在全科医生处接受 COPD 治疗且未出现在专科统计中的患者。
