Exacerbations and healthcare resource utilization among COPD patients in a Swedish registry-based nation-wide study

Johansson, Gunnar; Mushnikov, V.; Bäckström, Tobias; Engström, Andreas; Khalid, Javaria Mona; Wall, Jennifer; Hoti, Fabian

doi:10.1186/s12890-018-0573-0

Cited by 24 publications

(21 citation statements)

References 16 publications

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“…COPD places a significant burden on patients and healthcare systems,2,11 and exacerbations, in particular, impose a significant burden, accounting for the majority of hospital admissions for patients with COPD 12,13. Health care resource utilization (HCRU) is measured in registry-based studies by hospitalizations and out-patient visits in order to describe the burden of the disease 14. A study based on registry data from Sweden demonstrated that patients with a history of severe exacerbations and high use of medication for COPD had an increased rate of exacerbations and HCRU 14.…”

Section: Introductionmentioning

confidence: 99%

“…Health care resource utilization (HCRU) is measured in registry-based studies by hospitalizations and out-patient visits in order to describe the burden of the disease 14. A study based on registry data from Sweden demonstrated that patients with a history of severe exacerbations and high use of medication for COPD had an increased rate of exacerbations and HCRU 14. As a result, the economic burden of the disease is substantial, and given the ageing populations in many countries, it is likely to continue to rise over time.…”

Section: Introductionmentioning

confidence: 99%

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<p>The Burden Of Chronic Obstructive Pulmonary Disease (COPD) In Finland: Impact Of Disease Severity And Eosinophil Count On Healthcare Resource Utilization</p>

Viinanen

Lassenius²,

Toppila³

et al. 2019

COPD

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PurposeThe burden associated with chronic obstructive pulmonary disease (COPD) is substantial. The objectives of this study were to describe healthcare resource utilization (HCRU) and HCRU-associated costs in patients with COPD in Finland, according to disease severity and blood eosinophil count (BEC).Patients and methodsThis non-interventional, retrospective registry study (GSK ID: HO-17-17558) utilized data from the specialist care hospital register. Data extraction was from first hospital visit with a COPD diagnosis (index date) from January 1, 2004 until December 31, 2015 or death. Patients (aged >18 years with ≥1 report of post-bronchodilation forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ratio <0.7) were categorized as having non-severe or severe COPD (FEV1 >50% or ≤50% of reference, respectively). Patients who were initially non-severe but progressed to severe were classified as having progressing COPD. Patients without spirometry registry data were classified as having clinically verified COPD. Patients were grouped according to BEC (≥300 cells/μL, <300 cells/μL or BEC unknown). HCRU, estimated associated costs and mortality were evaluated according to COPD severity and BEC.ResultsThere were 9042 patients with COPD; 340 non-severe, 326 progressing, 394 severe, and 7982 clinically verified. BEC was available for 31.8% of patients. The mean follow-up time was 3.7–6.5 years in the classified patient-groups. All-cause mortality was 46% during follow-up. Severe COPD was associated with more COPD-related HCRU and higher mortality than non-severe COPD. Patients with BEC ≥300 cells/μL had higher overall HCRU but improved survival compared with those with BEC <300 cells/μL. Overall direct costs were similar across COPD severity categories, 3300–3900€/patient-year, although COPD-related costs were higher in patients with severe versus non-severe COPD.ConclusionThis study demonstrated a substantial burden associated with severe and/or eosinophilic COPD for patients in Finland.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

<p>The Burden Of Chronic Obstructive Pulmonary Disease (COPD) In Finland: Impact Of Disease Severity And Eosinophil Count On Healthcare Resource Utilization</p>

Viinanen

Lassenius²,

Toppila³

et al. 2019

COPD

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“…Evidence suggests that comorbidities increase the risk for exacerbations and hospitalizations, reduce health status, and increase the risk of mortality in COPD patients. 4 – 11 Various comorbidities studied in patients with COPD include asthma; lung cancer; cardiovascular diseases, such as heart failure, ischemic heart disease, arrhythmias, peripheral vascular disease, and hypertension; osteoporosis; depression; anxiety; metabolic syndrome and diabetes; gastroesophageal reflux; bronchiectasis; and obstructive sleep apnea. 3 , 5 , 8 , 12 – 16 …”

Section: Introductionmentioning

confidence: 99%

Real-world retrospective cohort study ARCTIC shows burden of comorbidities in Swedish COPD versus non-COPD patients

Ställberg

Janson

Larsson

et al. 2018

npj Prim Care Resp Med

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This study aimed to generate real-world evidence to assess the burden of comorbidities in COPD patients, to effectively manage these patients and optimize the associated healthcare resource allocation. ARCTIC is a large, real-world, retrospective cohort study conducted in Swedish COPD patients using electronic medical record data collected between 2000 and 2014. These patients were studied for prevalence of various comorbidities and for association of these comorbidities with exacerbations, mortality, and healthcare costs compared with an age-, sex-, and comorbidities-matched non-COPD reference population. A total of 17,479 patients with COPD were compared with 84,514 non-COPD reference population. A significantly higher prevalence of various comorbidities was observed in COPD patients 2 years post-diagnosis vs. reference population, with the highest percentage increase observed for cardiovascular diseases (81.8% vs. 30.7%). Among the selected comorbidities, lung cancer was relatively more prevalent in COPD patients vs. reference population (relative risk, RR = 5.97, p < 0.0001). Ischemic heart disease, hypertension, depression, anxiety, sleep disorders, osteoporosis, osteoarthritis, and asthma caused increased mortality rates in COPD patients. Comorbidities that were observed to be significantly associated with increased number of severe exacerbations in COPD patients included heart failure, ischemic heart disease, depression/anxiety, sleep disorders, osteoporosis, lung cancer, and stroke. The cumulative healthcare costs associated with comorbidities over 2 years after the index date were observed to be significantly higher in COPD patients (€27,692) vs. reference population (€5141) (p < 0.0001). The data support the need for patient-centered treatment strategies and targeted healthcare resource allocation to reduce the humanistic and economic burden associated with COPD comorbidities.

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“…The overall readmission rate was 14%. The Swedish National study [21] found that among the 88,548 patients with COPD, CCI of female patients was (mean 2.5 ± 1.9), and of male patients was (mean 2.9 ± 2.1) (p < 0.001). The overall mean (SD) CCI score was 2.7 ± 2.0.…”

Section: Discussionmentioning

confidence: 97%

BODE Index Correlated with Charlson Comorbidity Index and Medical Burden in COPD

Ling¹,

Ma²,

Tsai³

et al. 2019

Preprint

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COPD is currently the fourth leading cause of death in the world. Globally, due to continued exposure to COPD risk factors and an aging population, the burden of COPD is expected to increase in the coming decades. The BODE (body mass index, airflow obstruction, dyspnea, and exercise capacity) index is a practical and multidimensional predictor for prognosis of COPD, and better than FEV1.We used the database of Kaohsiung Chang Gung Memorial Hospital medical center, Taiwan to analyze the correlation between BODE index, healthcare resource utilization, and Charlson comorbidity index (CCI). This retrospective study to collect COPD patients with complete BODE index data who had undergone a 6-minute walk examination in our hospital from January 2015 to December 2016. The medical cost and comorbidities database were analyzed from January 1, 2015, to August 31, 2017. Of 396 patients, 382 (96.5%) were male, with an average age of 71.3 ± 8.4 years. There was a significant association between the BODE index and the CCI of COPD patients (p < 0.001). Healthcare resource utilization was positively correlated with the BODE index during the 32 months of retrospective clinical outcomes: positively correlated with the number of hospitalizations (p<0.001), hospitalization days (p<0.001), hospitalization expenses (p=0.005), and total medical expenses (p=0.024), respectively. Our findings provide the crucial information for clinician to predict medical burden and comorbidities in patients with COPD by using BODE index.

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Exacerbations and healthcare resource utilization among COPD patients in a Swedish registry-based nation-wide study

Cited by 24 publications

References 16 publications

<p>The Burden Of Chronic Obstructive Pulmonary Disease (COPD) In Finland: Impact Of Disease Severity And Eosinophil Count On Healthcare Resource Utilization</p>

<p>The Burden Of Chronic Obstructive Pulmonary Disease (COPD) In Finland: Impact Of Disease Severity And Eosinophil Count On Healthcare Resource Utilization</p>

Real-world retrospective cohort study ARCTIC shows burden of comorbidities in Swedish COPD versus non-COPD patients

BODE Index Correlated with Charlson Comorbidity Index and Medical Burden in COPD

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