To our knowledge, this is the first epidemiological study investigating the influence of a psychiatric comorbidity on the course of COPD, lung cancer and TB at a national level. Our results emphasize the importance of detecting these major respiratory diseases in patients with psychiatric comorbidities and intensifying the treatment and follow up of these patients.
Background and objective The study aimed to evaluate the direct and indirect costs of systemic sclerosis (SSc) in cases with and without interstitial lung disease (ILD). Methods Cases diagnosed with SSc (2002–2015) were identified in the Danish National Patient Registry. Cases were matched 1:4 with non‐SSc controls from the general population. Data on costs were obtained from national databases. Excess cost was estimated as the annual cost per case subtracting the costs of the control. Results We identified 1869 cases and 7463 controls. Total excess cost (direct healthcare, elderly care and indirect costs) in the SSc‐ILD cohort was €29,725, and €17,905 in the non‐ILD SSc cohort. In‐ and out‐patient contacts and forgone earnings were the key drivers of costs in both cohorts. Healthcare costs were higher before and after the diagnosis compared with the controls. Men incurred higher excess healthcare costs than women. Hospitalization and outpatient services were the key drivers of the gender‐associated differences. Income from employment decreased more rapidly after diagnosis in the SSc‐ILD cohort than in the non‐ILD SSc cohort. Public transfer income increased after diagnosis, with the most pronounced difference in the SSc‐ILD cohort. Disability pension was the key driver of public transfer income. Conclusion SSc is associated with a significant individual and societal burden that is evident several years before and after the diagnosis. Total excess costs are higher in SSc‐ILD than in the non‐ILD SSc underlining the severity of pulmonary involvement. Initiatives to maintain work ability and to reduce hospital admissions may reduce the economic burden of SSc.
Background: Sarcoidosis is a systemic disease that primarily affects the younger population. Longitudinal studies of the economic burden of sarcoidosis are scarce. This study evaluates overall the economic burden of sarcoidosis in Denmark before and after initial diagnosis. Methods: We identified patients with sarcoidosis in the Danish National Patient Registry (1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010). All controls were randomly selected and matched concerning age, gender and residence. Data on direct and indirect costs, including frequency of primary and secondary sector contacts and procedures, medication, unemployment benefits and social transfer payments were extracted from national databases for patients and controls. Results: We identified 9119 patients with sarcoidosis and 36,432 matching controls. Patients with sarcoidosis had significantly higher rates of health-related contacts, higher usage of medication and more received unemployment and social payments compared with controls.The total health expenses were significantly higher in the sarcoidosis group 11 years before and 11 years after diagnosis than among controls.Income from public transfer payments was significantly higher in the sarcoidosis group five years prior of diagnosis until nine years post diagnosis. Especially women between 40 and 59 years have a lower income than their controls. Conclusion: Sarcoidosis has a socioeconomic impact on adults especially during their prime working and providing years and this is evident several years prior to and post diagnosis. The authors advocate that further research should focus on identifying the proportion of patients with sarcoidosis that imposes the largest economic burden. Increased focus on early diagnosis and disease management may reduce the socioeconomic burden of sarcoidosis.
The primary objective was to evaluate the prevalence and incidence of sarcoidosis, and secondly, to evaluate differences in incidence by age at diagnosis, gender, region, calendar year and treatment and to evaluate sarcoidosis-related diagnostic work-up. Methods: Patients diagnosed with sarcoidosis from 2001 to 2015 and information on diagnostic procedures three months before and after initial diagnosis were identified in the Danish National Patient Register. Incidence proportion and prevalence proportion were calculated using the total population count of Danish citizens. Results: We identified 8545 sarcoidosis cases. Mean age was 46.0 ± 15.0 years, male gender was overrepresented (56.2%) and systemic corticosteroid was initiated in 46% of cases. The prevalence was 77 per 100,000 citizens in 2015. From 2001 to 2015, the incidence varied from 11.3 to 14.8 per 100,000 per year. The age-associated incidence peaked at 30-39 years in both men (23.6 per 100,000 per year) and women (15.0 per 100,000 per year). Incidence varied from 10.4 to 15.7 per 100,000 per year among regions. In particular, the share of bronchoscopies and chest-computed tomography were high in the region with the highest incidence and low in the region with the lowest incidence. Invasive procedures were more frequently performed in patients treated with systemic corticosteroid. Conclusion:We find an increasing incidence and prevalence of sarcoidosis, with a peak incidence for both men and women between 30 and 39 years of age. The share of procedures performed seems to correlate well with incidence and disease severity.
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