Dombai Brigitta, Nagy Viktória, Ruzsics István, Németh László, Balázs Tamás, Sánta Balázs, Lázár Zsófia
Outpatient Health Care Services of Kispest, Pulmonology Centre, Budapest, Hungary.
Department of Pulmonology, Géza Hetényi Hospital of Jász-Nagykun-Szolnok County, Szolnok, Hungary.
PLoS One. 2025 May 5;20(5):e0320949. doi: 10.1371/journal.pone.0320949. eCollection 2025.
Medical costs of patients with chronic obstructive pulmonary disease (COPD) are high, however data from Eastern European countries are scarce. We aimed to study healthcare payments for patients with COPD on maintenance inhaled therapy in Hungary and analyse the trends and influencing factors between 2011 and 2019 in a retrospective financial database analysis.
We collected data of patients from the Hungarian National Insurance Fund, who were > 40 years old, received maintenance inhaled therapy > 90 days within 12 months prescribed for J41-44 International Classification of Diseases-10 codes. All-cause and COPD-specific healthcare costs were compared between 2011 and 2019. We used a generalized mixed regression model to analyse the effects of calendar years, age, sex, Charlson comorbidity index, status of incidence, annual duration of inhaled therapy, the number of COPD-related hospitalization and geographical regions.
We analysed the data of 227 254 patients. In 2019, cumulative all-cause and COPD-specific spendings reached 401.15 million and 118.14 million USD, respectively. Annual total and COPD-related costs per patient in 2011 vs. 2019 were 2707 ± 3598 vs. 3332 ± 4463 USD and 927 ± 1162 vs. 981 ± 1534 USD, respectively (mean ± standard deviation). The increase in all-cause costs was above, while the rise in COPD-related costs was below the Hungarian inflation rate. The costs of medication and inpatient care comprised of the highest payment segments. The number of COPD-related hospitalizations had the most significant effect on the expenditures, while comorbidity burden and spendings on inhaled maintenance therapy were related to all-cause and COPD-specific costs, respectively. Increasing age was associated to higher spendings, but women had lower costs.
The costs of inpatient care and medication are responsible for the largest segments of healthcare spendings for patients with COPD. Prevention of hospitalizations due to COPD and the close follow-up of comorbidities can help reduce medical costs.
慢性阻塞性肺疾病（COPD）患者的医疗费用高昂，但来自东欧国家的数据却很稀少。我们旨在研究匈牙利接受维持性吸入治疗的COPD患者的医疗支付情况，并通过回顾性财务数据库分析，剖析2011年至2019年间的趋势及影响因素。
我们从匈牙利国家保险基金收集了年龄大于40岁、在12个月内接受了超过90天维持性吸入治疗（国际疾病分类第10版代码J41 - 44）的患者数据。比较了2011年和2019年间的全因医疗费用和COPD特定医疗费用。我们使用广义混合回归模型分析历年、年龄、性别、查尔森合并症指数、发病状态、吸入治疗的年度时长、COPD相关住院次数以及地理区域的影响。
我们分析了227254名患者的数据。2019年，累积全因支出和COPD特定支出分别达到4.0115亿美元和1.1814亿美元。2011年与2019年每位患者的年度总费用和COPD相关费用分别为2707±3598美元与3332±4463美元，以及927±1162美元与981±1534美元（均值±标准差）。全因费用的增长高于匈牙利通货膨胀率，而COPD相关费用的增长低于该通胀率。药物和住院护理费用占支付的最大部分。COPD相关住院次数对支出影响最为显著，而合并症负担和吸入维持治疗费用分别与全因费用和COPD特定费用相关。年龄增长与支出增加相关，但女性费用较低。
住院护理和药物费用占COPD患者医疗支出的最大部分。预防COPD导致的住院以及密切随访合并症有助于降低医疗费用。
