Continuing to Confront COPD International Patient Survey: Economic Impact of COPD in 12 Countries.
Continuing to Confront COPD International Patient Survey: Economic Impact of COPD in 12 Countries.
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DOI：
10.1371/journal.pone.0152618
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Punekar Y
中科院分区：
文献类型：
--
作者：
Foo J;Landis SH;Maskell J;Oh YM;van der Molen T;Han MK;Mannino DM;Ichinose M;Punekar Y
继续面对慢性阻塞性肺病国际患者调查估计了12个国家的慢性阻塞性肺病患病率和负担。利用这项调查的数据，我们评估了慢性阻塞性肺病的经济影响。这项以人群为基础的横断面调查询问了4343名年龄在40岁及以上的受试者，满足基于自我报告的医生诊断或症状学的COPD病例定义。直接成本测量是基于慢性阻塞性肺病的恶化（治疗过的和需要急诊和/或住院治疗的）、与卫生保健专业人员的接触和慢性阻塞性肺病药物。间接成本是使用工作效率和活动损害量表从工作损失值计算出来的。综合直接和间接成本估算了每位患者的社会总成本。慢性阻塞性肺病的年度直接费用从504美元（韩国）到9981美元（美国）不等，其中住院治疗（5个国家）和家庭氧气治疗（3个国家）是直接费用的主要驱动因素。由于慢性阻塞性肺病而完全无法工作的患者比例从6%（意大利）到52%（美国和英国）不等，有8个国家报告这一比例≥20%。每位患者的社会总成本差异很大，从1,721美元（俄罗斯）到30,826美元（美国）不等，但各国一致的模式表明，COPD负担加重（症状、健康状况和更严重的疾病）和合并症数量较多的患者的成本更高。COPD的经济负担在各国都相当大，需要有针对性的资源来优化COPD管理，包括控制症状、预防恶化和有效治疗合并症。允许COPD患者继续工作的策略对于解决大量更广泛的社会成本非常重要。
The Continuing to Confront COPD International Patient Survey estimated the prevalence and burden of COPD across 12 countries. Using data from this survey we evaluated the economic impact of COPD. This cross-sectional, population-based survey questioned 4,343 subjects aged 40 years and older, fulfilling a case definition of COPD based on self-reported physician diagnosis or symptomatology. Direct cost measures were based on exacerbations of COPD (treated and those requiring emergency department visits and/or hospitalisation), contacts with healthcare professionals, and COPD medications. Indirect costs were calculated from work loss values using the Work Productivity and Activity Impairment scale. Combined direct and indirect costs estimated the total societal costs per patient. The annual direct costs of COPD ranged from $504 (South Korea) to $9,981 (USA), with inpatient hospitalisations (5 countries) and home oxygen therapy (3 countries) being the key drivers of direct costs. The proportion of patients completely prevented from working due to their COPD ranged from 6% (Italy) to 52% (USA and UK) with 8 countries reporting this to be ≥20%. Total societal costs per patient varied widely from $1,721 (Russia) to $30,826 (USA) but a consistent pattern across countries showed greater costs among those with increased burden of COPD (symptoms, health status and more severe disease) and a greater number of comorbidities. The economic burden of COPD is considerable across countries, and requires targeted resources to optimise COPD management encompassing the control of symptoms, prevention of exacerbations and effective treatment of comorbidities. Strategies to allow COPD patients to remain in work are important for addressing the substantial wider societal costs.