Chest
Volume 117, Issue 2, Supplement, February 2000, Pages 5S-9S
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The Economic Burden of COPD

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COPD is one of the leading causes of morbidity and mortality worldwide and imparts a substantial economic burden on individuals and society. Despite the intense interest in COPD among clinicians and researchers, there is a paucity of data on health-care utilization, costs, and social burden in this population. The total economic costs of COPD morbidity and mortality in the United States were estimated at $23.9 billion in 1993. Direct treatments for COPD-related illness accounted for $14.7 billion, and the remaining $9.2 billion were indirect morbidity and premature mortality estimated as lost future earnings. Similar data from another US study suggest that 10% of persons with COPD account for > 70% of all medical care costs. International studies of trends in COPD-related hospitalization indicate that although the average length of stay has decreased since 1972, admissions per 1,000 persons per year for COPD have increased in all age groups > 45 years of age. These trends reflect population aging, smoking patterns, institutional factors, and treatment practices.

Section snippets

Economic Burden of Disease

Economic burden, or cost-of-illness, studies provide insight into the economic impact that illness has on society as well as on individuals and families. This approach separates economic burden into disease-attributable direct and indirect costs. The direct costs are those associated with medical management of the illness. Indirect costs are those associated with output losses and family costs as a consequence of illness (loss of work time and productivity).

Chronic bronchitis and emphysema

Trends in COPD Hospital Discharges

Expenditures for hospitalizations represent > 70% of all COPD-related medical care costs. Thus, it is important to understand the trends in hospital-related care for COPD. Using data from the National Hospital Discharge Survey, investigators at the National Center for Health Statistics evaluated the trends in COPD-related hospital discharges. The first listed diagnosis on the hospital medical record identified the discharge as being COPD related. In the United States, an estimated 553,000

Cost-Effectiveness of Pharmacologic Treatments

Rutten-van Mölken and associates24 investigated the costs and effects of adding inhaled anti-inflammatory therapy to inhaled β2-agonist therapy by analyzing data from a randomized trial of 274 adult participants aged 18 to 60 years. Patients were selected for inclusion if they met the age criteria and had been diagnosed as having moderately severe obstructive airway disease, as defined by pulmonary function criteria. Patients were eligible if they had either asthma or COPD, but most patients

Conclusion

Because COPD is highly prevalent and can be severely disabling, medical expenditures for treating COPD can represent a substantial economic burden for societies and for public and private health insurers worldwide. Nevertheless, very little economic information concerning COPD is available in the literature today. Studies of the economic burden of illness have been conducted in only a few developed countries. Although studies of direct medical-care costs may be less relevant to the developing

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