Elsevier

Respiratory Medicine

Volume 106, Issue 12, December 2012, Pages 1734-1742
Respiratory Medicine

Factors associated with high healthcare resource utilisation among COPD patients

https://doi.org/10.1016/j.rmed.2012.09.009Get rights and content
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Summary

Background

Chronic obstructive pulmonary disease (COPD) places a huge economic burden on healthcare systems, especially patients with frequent exacerbations and co-morbidities.

Objectives

To identify factors associated with high utilisation of healthcare resources in a population of patients with COPD.

Method

We conducted an observational, cross-sectional, multicentre study with the aim of identifying the factors associated with high resource utilisation among patients with COPD. Sociodemographic and anthropometric characteristics of the study population, as well as data on health-related quality of life, respiratory symptoms, presence of anxiety and depression, physical activity and lung function were collected. We examined the relationship between these variables and high utilisation of healthcare resources, by performing a multivariate analysis based on a logistic regression model.

Results

115 patients (64 were high users of healthcare resources, and 51 control patients) from 13 hospitals were selected. Patients presenting high resource utilisation had worse FEV1, worse basal SpO2, less distance walked in the 6-minute walk test, and increased dyspnoea. They also had a worse BODE index, worse scores in all dimensions of the EURO-QOL 5D and the LCADL scale, and displayed a higher prevalence of depression. Multivariate analysis yielded a statistically significant association between SpO2, LCADL scores, serum fibrinogen values and total leukocyte count, and high healthcare resource utilisation.

Conclusions

COPD patients who incur higher healthcare resource utilisation show reduced physical activity, increased respiratory failure and increased systemic inflammation.

Keywords

COPD
Hospitalisation
Physical activity
Healthcare resource utilisation
Systemic inflammation

Abbreviations

BMI
body mass index
COPD
Chronic Obstructive Pulmonary Disease
CRP
C-reactive protein
FEV1
forced expiratory volume in one second
FVC
forced vital capacity
EQ-5D
EuroQol five-dimension questionnaire
GOLD
Global Initiative for Chronic Obstructive Lung Disease
GP
General practitioner
HADS
Hospital Anxiety and Depression Scale
ICU
Intensive care unit
LCDAL
London Chest Activity of Daily Living Scale
LTOT
long-term oxygen therapy
MRC
Medical Research Council
SABAs
short-acting beta-2 agonists
6MWT
six-minute walk test

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