Abstract
Objective:
To examine the occurrence rate and health care cost of acute exacerbations in patients with chronic obstructive pulmonary disease (COPD) in Dutch general practice.
Methods:
Data are from the COPD on Primary Care Treatment (COOPT) study, a randomised controlled trial investigating the effectiveness of fluticasone and N-acetylcysteine in COPD. For the 2-year period preceding trial inclusion, details on the occurrence and management of acute exacerbations were collected for each trial participant by retrospective general practice chart review. Patients were divided into subgroups of severity of airway obstruction based on their post-bronchodilator FEV1 percentage predicted value (FEV1 % predicted; 80%: no obstruction; 70-80%: mild obstruction; 50-70%: moderate obstruction; <50%: severe obstruction). Exacerbation-related health care costs were determined by counting the units of resources consumed and converting these into monetary values (荤).
Results:
Mean age of the 286 patients involved was 59.2 (SD 9.6) years, post-bronchodilator FEV1 % predicted was 67.1 (SD 16.2). Of all patients, 220 (77%) experienced at least one exacerbation during the 2-year observation period. Mean annual exacerbation rate was 0.88 (SD 0.79). The annual exacerbation rate did not differ between the subgroups of severity of airway obstruction (p=0.628). Mean health care cost per exacerbation was 荤67 (95% CI 57, 77). When costs were expressed as the annual exacerbation cost per patient, the mean costs in the severity subgroups were 荤80, 荤106, 荤122 and 荤183, respectively (p=0.013). The gradual increase of the annual exacerbation cost across severity subgroups was mainly attributable to more physician consultations and more prescriptions for bronchodilators and other reliever medication.
Conclusions:
The occurrence rate of exacerbations in COPD may not depend on the severity of airway obstruction, but the annual exacerbation-related health care cost per patient appear to increase as obstruction becomes more severe.
Article PDF
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Schermer, T., Saris, C., Chavannes, N. et al. The occurence and healthcare cost of acute exacerbations in patients with chronic obstructive pulmonary disease (COPD) managed in Dutch general practice. Prim Care Respir J 11, 95–96 (2002). https://doi.org/10.1038/pcrj.2002.92
Issue Date:
DOI: https://doi.org/10.1038/pcrj.2002.92
This article is cited by
-
Spirometrie
Bijblijven (2005)