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The Clinical and Economic Impact of Exacerbations of Chronic Obstructive Pulmonary Disease: A Cohort of Hospitalized Patients

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  • Francesco Blasi
  • Giancarlo Cesana
  • Sara Conti
  • Virginio Chiodini
  • Stefano Aliberti
  • Carla Fornari
  • Lorenzo Giovanni Mantovani

Abstract

Background: Chronic Obstructive Pulmonary Disease (COPD) is a common disease with significant health and economic consequences. This study assesses the burden of COPD in the general population, and the influence of exacerbations (E-COPD) on disease progression and costs. Methods: This is a secondary data analysis of healthcare administrative databases of the region of Lombardy, in northern Italy. The study included ≥ 40 year-old patients hospitalized for a severe E-COPD (index event) during 2006. Patients were classified in relation to the number and type of E-COPD experienced in a three-year pre-index period. Subjects were followed up until December 31st, 2009, collecting data on healthcare resource use and vital status. Results: 15857 patients were enrolled –9911 males, mean age: 76 years (SD 10). Over a mean follow-up time of 2.4 years (1.36), 81% of patients had at least one E-COPD with an annual rate of 3.2 exacerbations per person-year and an all-cause mortality of 47%. A history of exacerbation influenced the occurrence of new E-COPD and mortality after discharge for an E-COPD. On average, the healthcare system spent 6725€ per year per person (95%CI 6590–6863). Occurrence and type of exacerbations drove the direct healthcare cost. Less than one quarter of patients presented claims for pulmonary function tests. Conclusions: COPD imposes a substantial burden on healthcare systems, mainly attributable to the type and occurrence of E-COPD, or in other words, to the exacerbator phenotypes. A more tailored approach to the management of COPD patients is required.

Suggested Citation

  • Francesco Blasi & Giancarlo Cesana & Sara Conti & Virginio Chiodini & Stefano Aliberti & Carla Fornari & Lorenzo Giovanni Mantovani, 2014. "The Clinical and Economic Impact of Exacerbations of Chronic Obstructive Pulmonary Disease: A Cohort of Hospitalized Patients," PLOS ONE, Public Library of Science, vol. 9(6), pages 1-8, June.
    • Handle: RePEc:plo:pone00:0101228
    DOI: 10.1371/journal.pone.0101228
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    References listed on IDEAS

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    1. Douglas Mapel & Melissa Roberts, 2012. "New Clinical Insights into Chronic Obstructive Pulmonary Disease and Their Implications for Pharmacoeconomic Analyses," PharmacoEconomics, Springer, vol. 30(10), pages 869-885, October.
    2. Colin D Mathers & Dejan Loncar, 2006. "Projections of Global Mortality and Burden of Disease from 2002 to 2030," PLOS Medicine, Public Library of Science, vol. 3(11), pages 1-20, November.
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    1. Guglielmo Pacileo & Valeria D. Tozzi & Giovanni Sotgiu & Stefano Aliberti & Verdiana Morando & Francesco Blasi, 2019. "Administrative databases and clinical governance: The case of COPD," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(1), pages 177-186, January.
    2. Anees ur Rehman & Mohamed Azmi Ahmad Hassali & Sohail Ayaz Muhammad & Sabariah Noor Harun & Shahid Shah & Sameen Abbas, 2020. "The economic burden of chronic obstructive pulmonary disease (COPD) in Europe: results from a systematic review of the literature," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(2), pages 181-194, March.

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