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[Costs of exacerbations of chronic obstructive pulmonary disease in primary and secondary care in 2007--results of multicenter Polish study].
Pol Merkur Lekarski 2009; 26(153):208-14PM

Abstract

OBJECTIVES

Exacerbations are the key drivers of the costs of chronic obstructive pulmonary disease (COPD). This was the multicenter study of patients with COPD aimed at evaluating direct and indirect cost of exacerbations under usual clinical practice in primary and secondary care form societal perspective.

METHODS

It was observational, multicenter study with participation of 196 subjects with moderate or severe COPD, defined according to the current GOLD criteria. Patients presenting at the selected health care centres were included into the study in the sequential manner if they fulfilled the inclusion criteria. Exacerbations were divided into three different severity types according to Anthonisen N.R. classification. The management of exacerbations followed the usual clinical practice.

RESULTS

The number of exacerbations was 3.8 (3.2-4.4) in hospitalised patients and 1.7 (1.4-1.9) in ambulatory treated patients (1EURO was 3.85 PLN in 2007). The average direct health-care cost per exacerbation was PLN 5548 (95% CI = 4543; 6502) and PLN 524.1 (95% CI = 443; 614) in secondary and primary care respectively. In secondary care, the drug acquisition and oxygen therapy cost represented 18.3% of total direct costs, diagnostic tests costs accounted for 14.5%, the other hospital care and post-discharge followup visit costs 67%. Costs varied considerably with the severity of COPD before the exacerbation as well as the duration of COPD. In primary care the cost structure was as follows: diagnostic tests and medical devices 47.5%, drug acquisition costs 41% and doctors visits 11.4%. The average indirect costs per exacerbation were PLN 127.78 and PLN 100.56, in secondary and primary respectively (n.s)

CONCLUSION

Exacerbations of COPD are costly. Cost of exacerbation managed in secondary care is almost 10-fold higher than in primary care. Prevention of moderate-to-severe exacerbations, requiring hospitalization could be very cost-effective strategy.

Authors+Show Affiliations

Department of Immunology and Clinical Allergology, Central Clinical Hospital of the Ministry of National Defense, Military Institute of Health Services in Warsaw. krozyk@poczta.onet.plNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article
Multicenter Study

Language

pol

PubMed ID

19388534

Citation

Jahnz-Rózyk, Karina, et al. "[Costs of Exacerbations of Chronic Obstructive Pulmonary Disease in Primary and Secondary Care in 2007--results of Multicenter Polish Study]." Polski Merkuriusz Lekarski : Organ Polskiego Towarzystwa Lekarskiego, vol. 26, no. 153, 2009, pp. 208-14.
Jahnz-Rózyk K, Targowski T, From S. [Costs of exacerbations of chronic obstructive pulmonary disease in primary and secondary care in 2007--results of multicenter Polish study]. Pol Merkur Lekarski. 2009;26(153):208-14.
Jahnz-Rózyk, K., Targowski, T., & From, S. (2009). [Costs of exacerbations of chronic obstructive pulmonary disease in primary and secondary care in 2007--results of multicenter Polish study]. Polski Merkuriusz Lekarski : Organ Polskiego Towarzystwa Lekarskiego, 26(153), pp. 208-14.
Jahnz-Rózyk K, Targowski T, From S. [Costs of Exacerbations of Chronic Obstructive Pulmonary Disease in Primary and Secondary Care in 2007--results of Multicenter Polish Study]. Pol Merkur Lekarski. 2009;26(153):208-14. PubMed PMID: 19388534.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Costs of exacerbations of chronic obstructive pulmonary disease in primary and secondary care in 2007--results of multicenter Polish study]. AU - Jahnz-Rózyk,Karina, AU - Targowski,Tomasz, AU - From,Sławomir, PY - 2009/4/25/entrez PY - 2009/4/25/pubmed PY - 2009/5/13/medline SP - 208 EP - 14 JF - Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego JO - Pol. Merkur. Lekarski VL - 26 IS - 153 N2 - OBJECTIVES: Exacerbations are the key drivers of the costs of chronic obstructive pulmonary disease (COPD). This was the multicenter study of patients with COPD aimed at evaluating direct and indirect cost of exacerbations under usual clinical practice in primary and secondary care form societal perspective. METHODS: It was observational, multicenter study with participation of 196 subjects with moderate or severe COPD, defined according to the current GOLD criteria. Patients presenting at the selected health care centres were included into the study in the sequential manner if they fulfilled the inclusion criteria. Exacerbations were divided into three different severity types according to Anthonisen N.R. classification. The management of exacerbations followed the usual clinical practice. RESULTS: The number of exacerbations was 3.8 (3.2-4.4) in hospitalised patients and 1.7 (1.4-1.9) in ambulatory treated patients (1EURO was 3.85 PLN in 2007). The average direct health-care cost per exacerbation was PLN 5548 (95% CI = 4543; 6502) and PLN 524.1 (95% CI = 443; 614) in secondary and primary care respectively. In secondary care, the drug acquisition and oxygen therapy cost represented 18.3% of total direct costs, diagnostic tests costs accounted for 14.5%, the other hospital care and post-discharge followup visit costs 67%. Costs varied considerably with the severity of COPD before the exacerbation as well as the duration of COPD. In primary care the cost structure was as follows: diagnostic tests and medical devices 47.5%, drug acquisition costs 41% and doctors visits 11.4%. The average indirect costs per exacerbation were PLN 127.78 and PLN 100.56, in secondary and primary respectively (n.s) CONCLUSION: Exacerbations of COPD are costly. Cost of exacerbation managed in secondary care is almost 10-fold higher than in primary care. Prevention of moderate-to-severe exacerbations, requiring hospitalization could be very cost-effective strategy. SN - 1426-9686 UR - https://www.unboundmedicine.com/medline/citation/19388534/[Costs_of_exacerbations_of_chronic_obstructive_pulmonary_disease_in_primary_and_secondary_care_in_2007__results_of_multicenter_Polish_study]_ L2 - http://www.diseaseinfosearch.org/result/7979 DB - PRIME DP - Unbound Medicine ER -