Direct costs of chronic obstructive pulmonary disease among managed care patients.

  • Dalal A
  • Christensen L
  • Liu F
 et al. 
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PURPOSE: To estimate patient- and episode-level direct costs of chronic obstructive pulmonary disease (COPD) among commercially insured patients in the US. METHODS: In this retrospective claims-based analysis, commercial enrollees with evidence of COPD were grouped into five mutually exclusive cohorts based on the most intensive level of COPD-related care they received in 2006, ie, outpatient, urgent outpatient (outpatient care in addition to a claim for an oral corticosteroid or antibiotic within seven days), emergency department (ED), standard inpatient admission, and intensive care unit (ICU) cohorts. Patient- level COPD-related annual health care costs, including patient- and payer-paid costs, were compared among the cohorts. Adjusted episode-level costs were calculated. RESULTS: Of the 37,089 COPD patients included in the study, 53% were in the outpatient cohort, 37% were in the urgent outpatient cohort, 3% were in the ED cohort, and the standard admission and ICU cohorts together comprised 6%. Mean (standard deviation, SD) annual COPD-related health care costs (2008 US$) increased across the cohorts (P < 0.001), ranging from $2003 ($3238) to $43,461 ($76,159) per patient. Medical costs comprised 96% of health care costs for the ICU cohort. Adjusted mean (SD) episode-level costs were $305 ($310) for an outpatient visit, $274 ($336) for an urgent outpatient visit, $327 ($65) for an ED visit, $9745 ($2968) for a standard admission, and $33,440 for an ICU stay. CONCLUSION: Direct costs of COPD-related care for commercially insured patients are driven by hospital stays with or without ICU care. Exacerbation prevention resulting in reduced need for inpatient care could lower costs.

Author-supplied keywords

  • Adult
  • Aged
  • Ambulatory Care
  • Ambulatory Care: economics
  • Chronic Obstructive
  • Chronic Obstructive: economics
  • Chronic Obstructive: therapy
  • Cost Savings
  • Databases as Topic
  • Drug Costs
  • Emergency Service
  • Female
  • Health Care Costs
  • Health Expenditures
  • Hospital
  • Hospital: economics
  • Humans
  • Insurance Claim Reporting
  • Intensive Care
  • Intensive Care: economics
  • Length of Stay
  • Length of Stay: economics
  • Male
  • Managed Care Programs
  • Managed Care Programs: economics
  • Middle Aged
  • Patient Admission
  • Patient Admission: economics
  • Pulmonary Disease
  • Respiratory System Agents
  • Respiratory System Agents: economics
  • Respiratory System Agents: therapeutic use
  • Retrospective Studies
  • United States

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  • Anand A Dalal

  • Laura Christensen

  • Fang Liu

  • Aylin A.A. Riedel

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