Elsevier

Respiratory Medicine

Volume 105, Issue 3, March 2011, Pages 402-409
Respiratory Medicine

The cost of COPD exacerbations: A university hospital – based study in Greece

https://doi.org/10.1016/j.rmed.2010.09.020Get rights and content
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Summary

Background

Hospitalization attributed to severe exacerbations is the major cost driver of Chronic Obstructive Pulmonary Disease (COPD). Given that in Greece no previous studies have addressed the economic burden of COPD, the aim of the study was to examine the hospitalization cost of COPD patients with severe exacerbations in the region of Thrace.

Methods

Sample consisted of 142 COPD patients with severe exacerbations who were admitted to the pneumonology department of the University Teaching Hospital of Alexandroupolis (UTHA) in 2006 and 2007. Data collection was performed retrospectively and resource utilization was derived from patients’ files. General Linear Model univariate analysis was applied in order to test the influence of disease severity on costs.

Results

Mean actual cost per severe exacerbation was €1711; the amount of €621 is reimbursed by social security funds. Price discrepancies are observed between the actual and the nominal cost per patient in all disease stage categories. Mean hospitalization cost per COPD patient increases slightly with the severity of the disease. However, in the very severe stage it greatly increases mainly due to Intensive Care Unit (ICU) admission. In multivariate analysis the length of stay and the stage of the disease were both related to significantly increased costs, while the existence of co-morbidities exhibited marginal significant relation to increased cost.

Conclusions

The cost estimation of severe exacerbations is important as it could trigger further research and also provide the opportunity of creating national epidemiological and economic data. Such data could contribute to the estimation of the total economic and societal burden of COPD in the country.

Keywords

COPD
Exacerbations
Hospitalization
Cost
Rural
Greece

Abbreviation

ABC
activity based costing
COPD
chronic obstructive pulmonary disease
CVD
cardiovascular disease
GOLD
global initiative for chronic obstructive pulmonary disease
HRQoL
health related quality of life
LoS
length of stay
ICU
intensive care unit
NHS
national health system
SD
standard deviation
CI
confidence intervals
Q1
quarter 1
Q3
quarter 3
UTHA
University Teaching Hospital of Alexandroupolis

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1

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