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重度慢性阻塞性肺疾病急性加重期费用增加的相关因素:土耳其胸科学会慢性阻塞性肺疾病委员会

Factors Associated with Increasing Costs in Severe Chronic Obstructive Pulmonary Disease Exacerbation: Turkish Thoracic Society Chronic Obstructive Pulmonary Disease Assembly.

作者信息

Baha Ayşe, Köktürk Nurdan, Baysan Caner, Öztürk Burcu, Cengiz Sümeyye Kodalak, Varol Yelda, Mertoğlu Aydan, Çırak Ali Kadri, Turan Onur, Dursunoğlu Neşe, Savurmuş Nilüfer, Gürgün Alev, Elmas Funda, Çöplü Lütfi, Sertçelik Ümran, Yıldız Reyhan, İpek Özmen, Alpaydın Aylin Özgen

机构信息

Department of Chest Diseases, Girne American University Faculty of Medicine, Girne, Turkish Republic of Northern Cyprus.

Department of Chest Diseases, Girne Doctor Akçiçek State Hospital, Girne, Turkish Republic of Northern Cyprus.

出版信息

Thorac Res Pract. 2024 Jan 3;25(1):17-25. doi: 10.5152/ThoracResPract.2024.23065.

Abstract

Chronic obstructive pulmonary disease (COPD) that is the third leading cause of death in the world is one of the main economic burden. The cost is primarily due to COPD exacerbations and hospitalizations. We aimed to determine the factors associated with increasing costs in severe COPD exacerbation. It was a multicenter and prospective observational recording study. 294 patients who severe COPD exacerbation were included in the study. An amount of more than 429.58 euros was accepted as increasing costs (IC). Factors associated with IC were determined by regression analysis. Mean age was 69.90 ± 9.79/years (minimum: 40 maximum: 95), mean costs were 594.9 ± 70.9 euros. About 83.7% of the patients were male, 24.1% (71) were active smokers, and 81% (238) had at least 1 comorbidity. Factors associated with IC in the regression analysis were delay of discharge (due to prolonged consultation), antibiotic use longer than 7 days, need to enteral/parenteral feeding, application of pulmonary rehabilitation (physiotherapy) at hospitalization, and refusal to be discharged. The increasing costs in severe COPD exacerbation depends not only treatment but also the patient's social status and hospital-related factors. We think that the cost of severe COPD exacerbation can be reduced by interventions on interchangeable factors such as patient's social status and hospital-related factors.

摘要

慢性阻塞性肺疾病(COPD)是世界上第三大死因,也是主要的经济负担之一。其费用主要源于COPD急性加重和住院治疗。我们旨在确定与重度COPD急性加重费用增加相关的因素。这是一项多中心前瞻性观察记录研究。294例重度COPD急性加重患者纳入研究。超过429.58欧元的费用被视为费用增加(IC)。通过回归分析确定与IC相关的因素。平均年龄为69.90±9.79岁(最小:40岁,最大:95岁),平均费用为594.9±70.9欧元。约83.7%的患者为男性,24.1%(71例)为现吸烟者,81%(238例)至少有一种合并症。回归分析中与IC相关的因素包括出院延迟(由于会诊时间延长)、抗生素使用超过7天、需要肠内/肠外营养、住院期间进行肺康复(物理治疗)以及拒绝出院。重度COPD急性加重费用增加不仅取决于治疗,还取决于患者的社会状况和医院相关因素。我们认为,通过对患者社会状况和医院相关因素等可互换因素进行干预,可以降低重度COPD急性加重的费用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b5a/11158616/3dbd11eecdd3/trp-25-1-17_f001.jpg

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