Medical Utilization and Cost in Patients with Overlap Syndrome of Chronic Obstructive Pulmonary Disease and Asthma
Medical Utilization and Cost in Patients with Overlap Syndrome of Chronic Obstructive Pulmonary Disease and Asthma
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DOI：
10.3109/15412555.2013.831061
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发表时间：
2014-04-01
影响因子：
2.2
通讯作者：
Lee, Sang Do
中科院分区：
文献类型：
--
作者：
Rhee, Chin Kook;Yoon, Hyoung Kyu;Lee, Sang Do
背景资料：关于慢性阻塞性肺疾病（COPD）和哮喘重叠综合征患者的医疗利用和费用的信息很少。本研究目的在分析重叠症候群病患的医疗利用与医疗成本，并与非气喘的慢性阻塞性肺病病患进行比较。方法：使用2009年韩国国民健康保险（NHI）数据库，确定COPD患者。还分析了医疗利用和费用。结果如下：在总计185，147例确定患有COPD的患者中，101，004例患者被分类为COPD和哮喘的重叠综合征，84，143例COPD患者不伴哮喘。2009年，重叠综合征组患者的急诊就诊率、入院率和重症监护室入院率分别为14.6%、30.5%和0.5%，而无哮喘的COPD患者组分别为5.0%、14.1%和0.2%（所有比较均为p < 0.05）。重叠综合征患者的门诊和住院医疗费用分别为790 +/- 71美元/人和3，373 +/-4，628美元/人，无哮喘的COPD患者分别为413 +/- 512美元和3，010 +/-5，013美元/人（所有比较p < 0.05）。多元线性回归分析显示，年龄、性别、重叠综合征、最近一年住院、社会经济地位低、医院使用类型是影响医疗利用和费用的重要因素。结论：重叠综合征患者的医疗利用和医疗费用均高于无哮喘的COPD患者。
Background: Little information is available regarding medical utilization and cost in patients with overlap syndrome of chronic obstructive pulmonary disease (COPD) and asthma. The purpose of this study is to analyze medical utilization and cost in patients with overlap syndrome and to compare them to COPD patients without asthma. Methods: Using the 2009 Korean National Health Insurance (NHI) database, COPD patients were identified. Medical utilization and costs were also analyzed. Results: Of a total of 185,147 patients identified with COPD, 101,004 patients were classified with overlap syndrome of COPD and asthma and 84,143 patients with COPD without asthma. In 2009, the percentages of emergency room visits, admissions, and intensive care unit admissions were 14.6%, 30.5%, and 0.5%, respectively, in the patients with overlap syndrome group and 5.0%, 14.1%, and 0.2%, respectively, in the COPD patients without asthma group (p < 0.05 for all comparisons). The cost of medical utilization was 790 +/- 71 US dollars per person and 3,373 +/- 4,628 dollars per person for outpatient and inpatient services, respectively, in the patients with overlap syndrome and 413 +/- 512 and 3,010 +/- 5,013, respectively, in the COPD patients without asthma (p < 0.05 for all comparisons). Multiple linear regression showed that age, sex, overlap syndrome, hospitalization in the last year, low socioeconomic status, and type of hospital use were significant factors affecting medical utilization and cost. Conclusions: In patients with overlap syndrome, both medical utilization and cost were higher than in COPD patients without asthma.