Predicting the costs of managing patients with chronic obstructive pulmonary disease.
Predicting the costs of managing patients with chronic obstructive pulmonary disease.
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预测治疗慢性阻塞性肺病患者的费用。
DOI：
10.1016/j.rmed.2005.03.001
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发表时间：
2005
影响因子：
4.3
通讯作者：
Spencer,MichaelD
中科院分区：
文献类型：
--
作者：
Mapel,DouglasW;McMillan,GarnettP;Frost,FloydJ;Hurley,JudithS;Picchi,MariaA;Lydick,Eva;Spencer,MichaelD
慢性阻塞性肺疾病（COPD）的经济后果是相当大的，尽管预测成本的最佳因素在很大程度上是未知的。本研究采用以人群为基础的队列，确定指标年内最能预测次年直接医疗费用增加的临床因素，并建立描述COPD成本变化的预测模型。选取1998年和1999年在某地区卫生系统登记的2116例COPD患者的医疗记录和医疗资源利用数据，提取其症状、吸烟史、慢性疾病和肺功能数据等信息。从数据库中提取1999年每个受试者的所有住院、门诊和药房使用数据。每个个体的总成本被转换成对数尺度。定义了成本变化的潜在原因（预测变量）并将其分类为集合（或域）。每个域拟合多个线性回归模型。研究表明，以预测的FEV1%评估的气流阻塞严重程度是未来医疗资源利用的一个重要但微弱的预测指标——先前的住院和家庭氧气使用、合并症的存在和呼吸困难症状是更好的成本预测指标。那些对新的COPD治疗和疾病管理计划的经济效益感兴趣的人需要仔细考虑这些因素。
The economic consequences of chronic obstructive pulmonary disease (COPD) are considerable, although the factors that best predict costs are largely unknown. This study used a population-based cohort to identify the clinical factors during an index year that were most predictive of increased direct medical costs in the subsequent year, and to develop a predictive model that described the cost variations in COPD. The medical records of 2116 patients enrolled in one regional health system who had COPD and healthcare resource utilisation data for 1998 and 1999, were abstracted for information about symptoms, smoking history, chronic illnesses, and pulmonary function data. All inpatient, outpatient and pharmacy utilisation data for each subject for 1999 were extracted from the database. Total costs for each individual were transformed to a log scale. Potential causes of cost variability (predictor variables) were defined and classified into sets (or domains). Multiple linear regression models were fitted for each domain. The study demonstrated that severity of airflow obstruction, as assessed by FEV1% predicted, is a significant but weak predictor of future healthcare resource utilisation—prior hospitalisation and home oxygen use, the presence of comorbid conditions and symptoms of dyspnoea are better predictors of costs. Those interested in the economic benefits of new COPD treatments and disease management programs need to carefully account for these factors.
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医疗保健支付者的决策。
影响因子：
4.3
作者：
M. Levine;R. Taylor;M. Ryan;M. Sculpher
通讯作者：
M. Sculpher
慢性支气管炎急性发作的治疗费用。
影响因子：
3.2
作者：
M. Niederman;J. Mccombs;A. Unger;Amit Kumar;R. Popovian
通讯作者：
R. Popovian
吸入皮质类固醇联合/不联合长效β-激动剂可降低慢性阻塞性肺病患者再住院和死亡的风险
DOI：
10.1007/bf03256640
发表时间：
2003
期刊：
American Journal of Respiratory Medicine
影响因子：
--
作者：
J. Soriano;V. Kiri;N. Pride;J. Vestbo
通讯作者：
J. Vestbo
社区获得性肺炎指南：指导较多，但证据不多
影响因子：
24.3
作者：
M. Woodhead
通讯作者：
M. Woodhead
影响因子：
3.2
作者：
M. Faulkner;D. Hilleman
通讯作者：
D. Hilleman