Seifer FD, Hansen G, Weycker D. Health-care utilization and expenditures among patients with comorbid bronchiectasis and chronic obstructive pulmonary disease in US clinical practice.
Chron Respir Dis 2019;
16:1479973119839961. [PMID:
30961354 PMCID:
PMC6456842 DOI:
10.1177/1479973119839961]
[Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Recent research suggests that bronchiectasis (BE) may be more common than
previously believed and that comorbid chronic obstructive pulmonary disease
(COPD) is widespread in this patient population. Little is known about the
economic burden among patients with BE, and less is known about the burden among
those with comorbid BE + COPD. A retrospective matched-cohort design and data
from a US health-care claims repository were employed. From the source
population comprising adults who had comprehensive medical/drug benefits for ≥1
day in 2013 (i.e. the referent year) and evidence of BE and/or COPD at any time
from 2009 to 2013, patients with BE + COPD were age/sex-matched (1:1:1) to
patients with BE only and patients with COPD only. For each matched subgroup,
annualized levels of respiratory-related and all-cause health-care utilization
and expenditures in 2013 were summarized. Source population included 679,679
patients; among those with BE (n = 31,027), 50% had comorbid
COPD. Mean (95% CI) annual levels of respiratory-related utilization and
expenditures among matched patients with BE + COPD (n = 11,685)
were higher by 2.4–3.5 times versus patients with BE only and 2.0–2.5 times
versus patients with COPD only: hospitalizations, 0.39 (0.37–0.41) versus 0.11
(0.09–0.12) and 0.16 (0.14–0.17); ambulatory encounters, 16.5 (16.1–16.9) versus
6.8 (6.6–7.0) and 8.2 (7.9–8.4); and total expenditures, US$15,685
(14,693–16,678) versus US$5605 (5059–6150) and US$6262 (5655–6868).
Respiratory-related utilization and expenditures are high among patients with BE
or COPD receiving medical care in US clinical practice and are especially high
among those with comorbid BE + COPD receiving medical care, emphasizing the
importance of identifying and treating this unique patient population. Funding
for this research was provided by RespirTech to Policy Analysis Inc. (PAI).
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