The Economic Burden of Chronic Obstructive Pulmonary Disease in Greece

Economic Burden of Chronic Obstructive Pulmonary Disease: A Systematic Review

Globally, providing evidence on the economic burden of chronic obstructive pulmonary disease (COPD) is becoming essential as it assists the health authorities to efficiently allocate resources. This study aimed to summarize the literature on economic burden evidence for COPD from 1990 to 2019. This study examined the economic burden of COPD through a systematic review of studies from 1990 to 2019. A search was done in online databases, including Web of Science, PubMed/Medline, Scopus, and the Cochrane Library. After screening 12,734 studies, 43 articles that met the inclusion criteria were identified. General study information and data on direct, indirect, and intangible costs were extracted and converted to 2018 international dollars (Int$). Findings revealed that the total direct costs ranged from Int$ 52.08 (India) to Int$ 13,776.33 (Canada) across 16 studies, with drug costs rannging from Int$ 70.07 (Vietnam) to Int$ 8,706.9 (China) in 11 studies. Eight studies explored indirect costs, while one highlighted caregivers' direct costs at approximately Int$ 1,207.8 (Greece). This study underscores the limited research on COPD caregivers' economic burdens, particularly in developing countries, emphasizing the importance of increased research support, particularly in high-resource settings. This study provides information about the demographics and economic burden of COPD from 1990 to 2019. More strategies to reduce the frequency of hospital admissions and acute care services should be implemented to improve the quality of COPD patients' lives and reduce the disease's rising economic burden.

Hospitalization costs of COPD cases and its associated factors: an observational study at two large public tertiary hospitals in Henan Province, China

BACKGROUND

The increasing prevalence of Chronic Obstructive Pulmonary Disease (COPD) has imposed a considerable economic burden. However, there remains a paucity of relevant evidence regarding the hospitalization costs of COPD cases. Therefore, in this study, we aimed to assess the hospitalization costs among COPD cases and investigate the factors that contribute to their costs in Henan Province, China.

METHODS

We enrolled a total of 1697 cases who were discharged with a diagnosis of COPD from January 1, 2020 to December 31, 2020, into the study. Demographic and clinical characteristics of the cases were obtained from the hospital information system (HIS) of two large tertiary hospitals in Henan Province, China. The factors associated with hospitalization costs were examined using a multiple linear regression model.

RESULTS

Total hospitalization costs of 1697 COPD cases were $5,419,011, and the median was $1952 (IQR:2031). Out-of-pocket fees accounted for 43.95% of the total hospitalization costs, and the median was $938 (IQR:956). Multiple linear regression analysis revealed that hospitalization costs were higher among older cases, cases with more comorbidities, and cases with longer length of stay. Furthermore, hospitalization costs were higher in cases who paid through private expenses compared to those covered by Urban Employee Basic Medical Insurance. Additionally, we found that cases admitted through an outpatient clinic had higher hospitalization costs than those admitted through the emergency department.

CONCLUSION

Hospitalization costs of COPD cases are substantial. Strategies to reduce hospitalization costs, such as shortening LOS, optimizing payment plans, and preventing or managing complications, should be implemented to alleviate the economic burden associated with COPD hospitalizations.

The role of increased red cell distribution width as a negative prognostic marker in patients with COPD

INTRODUCTION

Chronic obstructive pulmonary disease (COPD) remains a major burden with no clinically applicable biomarkers.

AIM

To investigate the association of Red cell Distribution Width (RDW) values on admission with previous hospitalizations, need of non-invasive mechanical ventilation (NIMV) and long term oxygen therapy (LTOT) in patients with COPD.

METHODS

Patients with AECOPD admitted to our department during 2018 were included in the study.

RESULTS

One hundred sixty patients were enrolled (M/F 95/65, median age 71.00 years, mean FEV₁± SD = 46.6 ± 28.9). Median RDW was significantly higher for patients in need of NIMV (14.8, 95% CI: 14.2 to 15.6) than patients not in need of NIMV (13.5, 95% CI: 13.2 to 13.8) (p < 0.001). Median RDW was significantly higher for patients in need of LTOT (14.2, 95% CI: 13.7 to 14.6) compared to patients not receiving LTOT (13.2, 95% CI: 12.5 to 13.6) (p = 0.001). Patients with hospitalization during the last 12 months had increased RDW values compared to patients with no hospitalizations [median RDW 14.3, (95% CI: 13.5 to 14.9) versus median RDW 13.5, (95% CI: 13.1 to 13.9)](p = 0.001).

CONCLUSION

Patients with COPD in need of LTOT, NIMV or patients with previous hospitalizations presented with increased RDW values. Increased RDW values could serve as a negative prognostic marker in patients with COPD.

The Economic Burden of Asthma in Greece: A Cross-Sectional Study

BACKGROUND

The high prevalence rates of asthma worldwide and the chronic nature of the disease make asthma a major cause of morbidity, imposing a significant socio-economic burden in many countries. Specifically in Greece, the self-reported prevalence of asthma reached 9% in 2017.

OBJECTIVES

The objective of this study was to estimate the total management cost of asthma in Greece and its potential determinants.

METHODS

A population-based, random-digit-dialed telephone nationwide survey was conducted to recruit patients with asthma in Greece (n = 353). A structured questionnaire was used to collect data on demographic and lifestyle characteristics, exacerbations, asthma control, medical resource utilization, and productivity loss during the past 12 months. The total annual direct cost from the societal, payer, and patient perspective as well as the indirect cost was calculated. All costs refer to the year 2017 (€). The significance level was set to α = 0.05.

RESULTS

The mean (95% confidence interval) annual total cost per patient for asthma management from the societal, payer, and patient perspective was €895 (696-1105), €673 (497-861), and €151 (119-188), respectively. The direct medical cost accounted for almost 90% of the total cost, whereas only 4% was attributed to the indirect cost. The direct medical cost was mainly driven by the medication cost (48%). The total annual societal cost was statistically significantly higher in those with not well-controlled asthma (p = 0.014) and those experiencing exacerbations during the past 12 months (p < 0.001) than in their counterparts. The total annual economic burden of asthma in Greece was estimated at €727 million and €547 million from the societal and payer perspective, respectively.

CONCLUSION

Our findings indicate that asthma imposes a high economic burden on society and the healthcare system in Greece. Therefore, greater investment in interventions aimed at asthma control and prevention of acute exacerbations may reduce the overall burden of asthma in Greece.