Back to Journals » International Journal of Chronic Obstructive Pulmonary Disease » Volume 10 » Issue 1

COPD exacerbation frequency and its association with health care resource utilization and costs

Authors Dhamane AD, Moretz C, Zhou Y, Burslem K, Saverno K, Jain G, Renda A, Kaila S

Received 9 June 2015

Accepted for publication 13 October 2015

Published 3 December 2015 Volume 2015:10(1) Pages 2609—2618

DOI https://doi.org/10.2147/COPD.S90148

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Glenda Ernst

Peer reviewer comments 3

Editor who approved publication: Dr Richard Russell

Amol D Dhamane,1 Chad Moretz,2 Yunping Zhou,2 Kate Burslem,1 Kim Saverno,2 Gagan Jain,1 Andrew Renda,3 Shuchita Kaila1

1Boehringer Ingelheim Pharmaceuticals Inc., Ridgefield, CT, USA; 2Comprehensive Health Insights Inc., Louisville, KY, USA; 3Humana Inc., Louisville, KY, USA

Background: Chronic obstructive pulmonary disease (COPD) exacerbations account for a substantial proportion of COPD-related costs.
Objective: To describe COPD exacerbation patterns and assess the association between exacerbation frequency and health care resource utilization (HCRU) and costs in patients with COPD in a Medicare population.
Methods: A retrospective cohort study utilizing data from a large US national health plan was conducted including patients with a COPD diagnosis during January 1, 2007 to December 31, 2012, aged 40–89 years and continuously enrolled in a Medicare Advantage Prescription Drug plan. Exacerbation frequency, HCRU, and costs were assessed during a 24-month period following the first COPD diagnosis (follow-up period). Four cohorts were created based on exacerbation frequency (zero, one, two, and ≥three). HCRU and costs were compared among the four cohorts using chi-square tests and analysis of variance, respectively. A trend analysis was performed to assess the association between exacerbation frequency and costs using generalized linear models.
Results: Of the included 52,459 patients, 44.3% had at least one exacerbation; 26.3%, 9.5%, and 8.5% had one, two, and ≥three exacerbations in the 24-month follow-up period, respectively. HCRU was significantly different among cohorts (all P<0.001). In patients with zero, one, two, and ≥three exacerbations, the percentages of patients experiencing all-cause hospitalizations were 49.7%, 66.4%, 69.7%, and 77.8%, respectively, and those experiencing COPD-related hospitalizations were 0%, 40.4%, 48.1%, and 60.5%, respectively. Mean all-cause total costs (medical and pharmacy) were more than twofold greater in patients with ≥three exacerbations compared to patients with zero exacerbations ($27,133 vs $56,033; P<0.001), whereas a greater than sevenfold difference was observed in mean COPD-related total costs ($1,605 vs $12,257; P<0.001).
Conclusion: COPD patients frequently experience exacerbations. Increasing exacerbation frequency is associated with a multiplicative increase in all-cause and COPD-related costs. This underscores the importance of identifying COPD patients at risk of having frequent exacerbations for appropriate disease management.

Keywords: COPD, exacerbations, frequency, costs

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]

 

Readers of this article also read:

Medicinal clays improve the endurance of loaded inspiratory muscles in COPD: a randomized clinical trial of nonpharmacological treatment

Baldi S, Pinna GD, Bruschi C, Caldara F, Maestri R, Dacosto E, Rezzani A, Popovich E, Bellinzona E, Crotti P, Montemartini S, Fracchia C

International Journal of Chronic Obstructive Pulmonary Disease 2015, 10:2235-2248

Published Date: 23 October 2015

Lobe-based computed tomography assessment of airway diameter, airway or vessel number, and emphysema extent in relation to the clinical outcomes of COPD

Kurashima K, Takaku Y, Hoshi T, Kanauchi T, Nakamoto K, Takayanagi N, Yanagisawa T, Sugita Y, Kawabata Y

International Journal of Chronic Obstructive Pulmonary Disease 2015, 10:1027-1033

Published Date: 2 June 2015

Analysis of autonomic modulation after an acute session of resistance exercise at different intensities in chronic obstructive pulmonary disease patients

Nicolino J, Ramos D, Leite MR, Rodrigues FM, Silva BS, Tacao GY, Toledo AC, Vanderlei LC, Ramos EM

International Journal of Chronic Obstructive Pulmonary Disease 2015, 10:223-229

Published Date: 29 January 2015

Development of a lauric acid/albumin hybrid iron oxide nanoparticle system with improved biocompatibility

Zaloga J, Janko C, Nowak J, Matuszak J, Knaup S, Eberbeck D, Tietze R, Unterweger H, Friedrich RP, Duerr S, Heimke-Brinck R, Baum E, Cicha I, Dörje F, Odenbach S, Lyer S, Lee G, Alexiou C

International Journal of Nanomedicine 2014, 9:4847-4866

Published Date: 20 October 2014

Nanotechnology-based drug delivery systems for treatment of oral cancer: a review

Calixto G, Bernegossi J, Fonseca-Santos B, Chorilli M

International Journal of Nanomedicine 2014, 9:3719-3735

Published Date: 8 August 2014

Direct phosphorylation events involved in HIF-α regulation: the role of GSK-3β

Mennerich D, Dimova EY, Kietzmann T

Hypoxia 2014, 2:35-45

Published Date: 30 April 2014