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8847

Direct costs of chronic obstructive pulmonary disease among managed care patients

Original Research

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Authors: Anand A Dalal, Laura Christensen, Fang Liu, et al

Published Date September 2010 Volume 2010:5 Pages 341 - 349
DOI: http://dx.doi.org/10.2147/COPD.S13771

Anand A Dalal1, Laura Christensen2, Fang Liu3, Aylin A Riedel3
1US Health Outcomes, GlaxoSmithKline, Research Triangle Park, NC, USA; 2Health Economics Outcomes Research, i3 Innovus, Ann Arbor, MI, USA; 3Health Economics Outcomes Research, i3 Innovus, Eden Prairie, MN, USA

Purpose: To estimate patient- and episode-level direct costs of chronic obstructive pulmonary disease (COPD) among commercially insured patients in the US.
Methods: In this retrospective claims-based analysis, commercial enrollees with evidence of COPD were grouped into five mutually exclusive cohorts based on the most intensive level of COPD-related care they received in 2006, ie, outpatient, urgent outpatient (outpatient care in addition to a claim for an oral corticosteroid or antibiotic within seven days), emergency department (ED), standard inpatient admission, and intensive care unit (ICU) cohorts. Patient-level COPD-related annual health care costs, including patient- and payer-paid costs, were compared among the cohorts. Adjusted episode-level costs were calculated.
Results: Of the 37,089 COPD patients included in the study, 53% were in the outpatient cohort, 37% were in the urgent outpatient cohort, 3% were in the ED cohort, and the standard admission and ICU cohorts together comprised 6%. Mean (standard deviation, SD) annual COPD-related health care costs (2008 US$) increased across the cohorts (P < 0.001), ranging from $2003 ($3238) to $43,461 ($76,159) per patient. Medical costs comprised 96% of health care costs for the ICU cohort. Adjusted mean (SD) episode-level costs were $305 ($310) for an outpatient visit, $274 ($336) for an urgent outpatient visit, $327 ($65) for an ED visit, $9745 ($2968) for a standard admission, and $33,440 for an ICU stay.
Conclusion: Direct costs of COPD-related care for commercially insured patients are driven by hospital stays with or without ICU care. Exacerbation prevention resulting in reduced need for inpatient care could lower costs.

Keywords: health care cost, health expenditure, lung diseases, managed care




 

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Burden of COPD in a government health care system: a retrospective observational study using data from the US Veterans Affairs population
Clinical and economic outcomes for patients initiating fluticasone propionate/salmeterol combination therapy (250/50 mcg) versus anticholinergics in a comorbid COPD/depression population
Comparative cost-effectiveness of a fluticasone-propionate/salmeterol combination versus anticholinergics as initial maintenance therapy for chronic obstructive pulmonary disease
Cost trends among commercially insured and Medicare Advantage-insured patients with chronic obstructive pulmonary disease: 2006 through 2009
Severity of COPD at initial spirometry-confirmed diagnosis: data from medical charts and administrative claims
The role of fluticasone propionate/salmeterol combination therapy in preventing exacerbations of COPD
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