skip to content
Dovepress - Open Access to Scientific and Medical Research
View our mobile site

8849

Economic burden of chronic bronchitis in the United States: a retrospective case-control study

Original Research

(1568) Views  (436) Full article downloads

Authors: Christopher M Blanchette, Melissa H Roberts, Hans Petersen, et al 

Published Date January 2011 Volume 2011:6 Pages 73 - 81
DOI: http://dx.doi.org/10.2147/COPD.S15882

Christopher M Blanchette1, Melissa H Roberts1, Hans Petersen1, Anand A Dalal2, Douglas W Mapel3
1Division of Clinical and Outcomes Research, Lovelace Respiratory Research Institute, Kannapolis, NC, USA; 2US Health Outcomes, GlaxoSmithKline, Research Triangle Park, NC, USA; 3Lovelace Clinic Foundation, Albuquerque, NM, USA

Background: Chronic bronchitis (CB) is often misdiagnosed or diagnosed at a later stage of chronic obstructive pulmonary disease (COPD). We examined how this later diagnosis may impact health care costs and utilization during the 12 months prior to and 24 months post initial CB diagnosis.
Methods: This retrospective case-control analysis used claims data from a large US database from July 1, 2003 through June 30, 2007. Patients with CB aged 40 years and older were propensity matched (N = 11,674) to patients without evidence of COPD or asthma by demographics, CB diagnosis quarter/year, and comorbidities. Group differences were assessed using Student's t-test and Pearson chi-square test statistics.
Results: Six months prediagnosis, CB patients had higher frequencies of any hospitalization (9.6%, 6.7%; P < 0.05), emergency department/urgent care visits (13.3%, 6.7%; P < 0.05), and prescriptions (97.3%, 94.1%; P < 0.05). Six months postdiagnosis, CB patients had 5.6 times more hospitalizations (P < 0.05) and 3.1 times more emergency department/urgent care visits (P < 0.05) compared with controls. Mean total costs (US$) for CB patients 12 months prediagnosis were significantly higher than controls (months 12–7: $4212, $3826; P < 0.05; months 6–1: $5289, $4285; P < 0.05). CB patients had higher mean total costs ($8919; P < 0.05) 6 months postdiagnosis. Costs remained $2429 higher for CB patients 19–24 months postdiagnosis (P < 0.05).
Conclusion: Health care costs and utilization among CB patients are increased both prior to diagnosis and during the 2 years postdiagnosis. This study suggests that not accurately diagnosing CB early has a substantial impact on health care costs, and that the economic burden for CB patients remains elevated even after adjustment for comorbidities associated with COPD.

Keywords: chronic bronchitis, burden, economic, chronic obstructive pulmonary disease




 

Other articles by Dr Christopher Blanchette



Readers of this article also read:

Exacerbation rate, health status and mortality in COPD – a review of potential interventions
Burden of COPD in a government health care system: a retrospective observational study using data from the US Veterans Affairs population
Direct costs of chronic obstructive pulmonary disease among managed care patients
Comparative cost-effectiveness of a fluticasone-propionate/salmeterol combination versus anticholinergics as initial maintenance therapy for chronic obstructive pulmonary disease
Changing patterns in long-acting bronchodilator trials in chronic obstructive pulmonary disease
Vitamin D and responses to inhaled fluticasone in severe chronic obstructive pulmonary disease
Optimizing management of chronic obstructive pulmonary disease in the upcoming decade
Unicentric study of cell therapy in chronic obstructive pulmonary disease/pulmonary emphysema
Severity of COPD at initial spirometry-confirmed diagnosis: data from medical charts and administrative claims
Adherence to current guidelines for chronic obstructive pulmonary disease (COPD) among patients treated with combination of long-acting bronchodilators or inhaled corticosteroids
  • Journal Indexing

    See where all the Dove Press journals are indexed

  • Testimonials

    "You do a tremendous job!!" Ruben Restrepo, The University of Texas Health Science Center at San Antonio