Using the BODE Index and Comorbidities to Predict Health Utilization Resources in Chronic Obstructive Pulmonary Disease
Received 11 October 2019
Accepted for publication 5 February 2020
Published 19 February 2020 Volume 2020:15 Pages 389—395
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Prof. Dr. Chunxue Bai
Chin-Ling Li,1,2 Mei-Hsin Lin,1 Pei-Shiuan Chen,1 Yuh-Chyn Tsai,1,2 Lien-Shi Shen,1,2 Ho-Chang Kuo,1,3,4 Shih-Feng Liu1,4,5
1Department of Respiratory Therapy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung City, Taiwan; 2Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung City, Taiwan; 3Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung City, Taiwan; 4Chang Gung University College of Medicine, Taoyuan, Taiwan; 5Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung City, Taiwan
Correspondence: Shih-Feng Liu
Division of Pulmonary & Critical Care Medicine, Department of Internal Medicine, Department of Respiratory Therapy, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taiwan, No. 123, Ta-Pei Road, Niaosong District, Kaohsiung 833, Taiwan
Tel +886 7 731 7123 ext. 8199
Fax +886 7 732 24942
Background and Objective: Chronic Obstructive Pulmonary Disease (COPD) is a common chronic respiratory disease that in the long term may develop into respiratory failure or even cause death and may coexist with other diseases. Over time, it may incur huge medical expenses, resulting in a heavy socio-economy burden. The BODE (Body mass index, airflow Obstruction, Dyspnea, and Exercise capacity) index is a predictor of the number and severity of acute exacerbations of COPD. This study focused on the correlation between the BODE index, comorbidity, and healthcare resource utilization in COPD.
Patients and Methods: This is a retrospective study of clinical outcomes of COPD patients with complete BODE index data in our hospital from January 2015 to December 2016. Based on the patients’ medical records in our hospital’s electronic database from January 1, 2015 to August 31, 2017, we analyzed the correlation between BODE index, Charlson comorbidity index (CCI), and medical resources.
Results: Of the 396 patients with COPD who met the inclusion criteria, 382 (96.5%) were male, with an average age of 71.3 ± 8.4 years. Healthcare resource utilization was positively correlated with the BODE index during the 32 months of retrospective clinical outcomes. The study found a significant association between the BODE index and the CCI of COPD patients (p < 0.001). In-hospitalization expenses were positively correlated with CCI (p < 0.001). Under the same CCI, the higher the quartile, the higher the hospitalization expenses. BODE quartiles were positively correlated with number of hospitalizations (p < 0.001), hospitalization days (p < 0.001), hospitalization expenses (p = 0.005), and total medical expenses (p = 0.024).
Conclusion: This study demonstrates the value of examining the BODE index and comorbidities that can predict healthcare resource utilization in COPD.
Keywords: chronic obstructive pulmonary disease, BODE index, Charlson comorbidity index, medical burden, 6 min walk test
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