Document Detail

Healthcare utilization and costs among chronic bronchitis patients treated with maintenance medications from a US managed care population.
MedLine Citation:
PMID:  23336296     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: This study aimed to examine the real-world healthcare resource utilization (HCRU) and direct costs among chronic bronchitis (CB) patients treated with chronic obstructive pulmonary disease (COPD) maintenance medications.
METHODS: This retrospective analysis utilized administrative claims data from 14 US commercial managed care plans. Eligible patients were ≥40 years old, had ≥2 years of continuous enrollment, ≥1 CB (ICD-9-CM code 491.xx) hospitalization or emergency department (ED) visit or ≥2 office visits between 1/1/2004 and 5/31/2011, and had ≥2 pharmacy fills for COPD medications during follow-up (first fill served as the index date). All-cause and COPD-related HCRU and costs were assessed during follow-up. Multivariate models were utilized to identify predictors of total costs.
RESULTS: Treated CB patients (n = 17,382; 50.6% female; mean age 66.7 (SD = 11.4) years) had a mean of 7.6 (SD = 6.3) COPD maintenance medication fills during follow-up. Overall, 32.6% of patients had ≥1 COPD-related inpatient hospitalizations, 12.9% had ≥1 ED visit, and 81.8% had ≥1 office visit. Mean all-cause and COPD-related total costs were $25,747 (SD = $51,105) and $12,609 (SD = $36,801), respectively, during follow-up. Among the sub-group with ≥1 exacerbation during baseline year, 42.3% had ≥1 COPD-related inpatient hospitalization, 18.5% had ≥1 ED visit, and 88.2% had ≥1 office visit. Mean follow-up all-cause and COPD-related total costs were $29,861 (SD = $49,799) and $16,784 (SD = $34,170), respectively. The number of baseline exacerbations was a significant predictor of all-cause and COPD-related total costs during follow-up.
LIMITATIONS: This study lacked standard measures of CB severity; however, severity proxies were utilized.
CONCLUSION: HCRU and costs among CB patients were substantial during follow-up, despite treatment with COPD maintenance medications. Additional interventions aiming to prevent or reduce HCRU and costs among CB patients warrant exploration.
Azza AbuDagga; Shawn X Sun; Hiangkiat Tan; Caitlyn T Solem
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2013-01-29
Journal Detail:
Title:  Journal of medical economics     Volume:  16     ISSN:  1941-837X     ISO Abbreviation:  J Med Econ     Publication Date:  2013  
Date Detail:
Created Date:  2013-02-13     Completed Date:  2013-08-07     Revised Date:  2014-04-08    
Medline Journal Info:
Nlm Unique ID:  9892255     Medline TA:  J Med Econ     Country:  England    
Other Details:
Languages:  eng     Pagination:  421-9     Citation Subset:  IM    
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MeSH Terms
Bronchitis, Chronic / drug therapy,  economics*
Health Services / economics*,  utilization
Insurance Claim Review
Maintenance Chemotherapy / economics*
Managed Care Programs*
Middle Aged
Multivariate Analysis
Retrospective Studies
Severity of Illness Index
United States

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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