Beyond tobacco - the secondary impact of substance misuse in chronic obstructive lung disease.
Beyond tobacco - the secondary impact of substance misuse in chronic obstructive lung disease.
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DOI：
10.1080/02770903.2020.1847932
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发表时间：
2022-03
期刊：
影响因子：
--
通讯作者：
Zein J
中科院分区：
文献类型：
--
作者：
Macmurdo M;Lopez R;Udeh BL;Zein J
慢性阻塞性肺疾病，特别是慢性哮喘和COPD，影响全球超过5亿成年人，并且与高医疗保健支出和显著的疾病相关发病率相关。虽然物质使用障碍的直接影响是有据可查的，但对物质滥用在这一患者人群中的间接影响知之甚少。阻塞性肺病药物滥用的医疗费用和间接发病率尚未量化。确定药物滥用对美国慢性阻塞性肺疾病患者疾病严重程度、医疗保健利用和医疗保健费用的间接影响。利用2012-2015年国家再入院数据库（NRD）的数据，确定了诊断为COPD或哮喘的患者。记录的药物滥用，住院率，再入院的频率，入院严重程度和成本的标志物进行了评估，采用加权回归分析。确定了1，087，226例因哮喘或COPD而入院的患者。4.0%的患者记录了药物滥用。药物滥用与再入院几率增加30%和每次指数入院费用增加相关。我们的队列的额外指数入院费用总计2400万美元。药物滥用与慢性阻塞性肺疾病患者的医疗保健利用和医疗保健费用增加相关。针对这一患者人群的药物滥用有可能为医疗保健系统节省大量成本。
Chronic obstructive lung disease, specifically chronic asthma and COPD, impacts more than 500 million adults worldwide, and is associated with high healthcare spending and significant disease related morbidity. While the direct impact of substance use disorder is well documented, little is known about the indirect impact of substance misuse within this patient population. The healthcare cost and indirect morbidity secondary to substance misuse in obstructive lung disease has yet to be quantified. To determine the indirect impact of substance misuse on disease severity, healthcare utilization and healthcare costs in patients with chronic obstructive lung disease across the United States. Utilizing data from the 2012–2015 National Readmissions Database (NRD) patients with a diagnosis of COPD or asthma were identified. Documented substance misuse, rates of hospitalization, frequency of hospital readmission, markers of admission severity and cost were assessed utilizing weighted regression analysis. 1,087,226 patients with an index admission for asthma or COPD were identified. Substance misuse was documented in 4.0% of patients. Substance misuse was associated with a 30% increase in odds of readmission and a higher cost per index admission. The additional index admission costs totaled $24 million for our cohort. Substance misuse is associated with an increase in healthcare utilization and healthcare cost in patients with chronic obstructive lung disease. Targeting substance misuse in this patient population has the potential for significant cost savings to the healthcare system.
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