Abstract:
BACKGROUND:Patients with chronic obstructive pulmonary disease (COPD) often have multiple underlying comorbidities, which may lead to increased health care resource utilization (HCRU) and costs. OBJECTIVE:To describe the comorbidity profiles of COPD patients and examine the associations between the presence of comorbidities and HCRU or health care costs. METHODS:A retrospective cohort study utilizing data from a large US national health plan with a predominantly Medicare population was conducted. COPD patients aged 40-89 years and continuously enrolled for 12 months prior to and 24 months after the first COPD diagnosis during the period of January 01, 2009, through December 31, 2010, were selected. Eleven comorbidities of interest were identified 12 months prior through 12 months after COPD diagnosis. All-cause and COPD-related hospitalizations and costs were assessed 24 months after diagnosis, and the associations with comorbidities were determined using multivariate statistical models. RESULTS:Ninety-two percent of 52,643 COPD patients identified had at least one of the 11 comorbidities. Congestive heart failure (CHF), coronary artery disease, and cerebrovascular disease (CVA) had the strongest associations with all-cause hospitalizations (mean ratio: 1.56, 1.32, and 1.30, respectively; P<0.0001); other comorbidities examined had moderate associations. CHF, anxiety, and sleep apnea had the strongest associations with COPD-related hospitalizations (mean ratio: 2.01, 1.32, and 1.21, respectively; P<0.0001); other comorbidities examined (except chronic kidney disease [CKD], obesity, and osteoarthritis) had moderate associations. All comorbidities assessed (except obesity and CKD) were associated with higher all-cause costs (mean ratio range: 1.07-1.54, P<0.0001). CHF, sleep apnea, anxiety, and osteoporosis were associated with higher COPD-related costs (mean ratio range: 1.08-1.67, P<0.0001), while CVA, CKD, obesity, osteoarthritis, and type 2 diabetes were associated with lower COPD-related costs. CONCLUSION:This study confirms that specific comorbidities among COPD patients add significant burden with higher HCRU and costs compared to patients without these comorbidities. Payers may use this information to develop tailored therapeutic interventions for improved management of patients with specific comorbidities.
journal_name
Int J Chron Obstruct Pulmon Disauthors
Schwab P,Dhamane AD,Hopson SD,Moretz C,Annavarapu S,Burslem K,Renda A,Kaila Sdoi
10.2147/COPD.S112256subject
Has Abstractpub_date
2017-02-23 00:00:00pages
735-744eissn
1176-9106issn
1178-2005pii
copd-12-735journal_volume
12pub_type
杂志文章abstract:INTRODUCTION:According to guidelines, the diagnosis of COPD should be confirmed by post-bronchodilator (post-BD) airway obstruction on spirometry; however, in clinical practice, this is not always performed. The aim of this population-based study was to compare clinical characteristics and prognosis, assessed as mortal...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S127923
更新日期:2017-04-24 00:00:00
abstract:BACKGROUND:COPD is emerging as the third largest cause of human mortality worldwide after heart disease and stroke. Tobacco smoking, the primary risk factor for the development of COPD, induces increased expression of platelet-activating factor receptor (PAFr) in the lung epithelium. Nontypeable Haemophilus influenzae ...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S108698
更新日期:2016-07-25 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Pulmonary Daoyin (PD) (evolved from ancient Chinese daoyin skills), is a rehabilitation technology that combines specially designed movements of the arms and body and controlled breathing exercises, to improve the physiological and psychological status of patients with chronic respiratory disea...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.2147/COPD.S117461
更新日期:2017-08-04 00:00:00
abstract:Introduction:COPD is an inflammatory airway pathology associated with recurrent infection by nontypeable Haemophilus influenzae (NTHi) that is not effectively managed by macrolide antibiotic therapy. We hypothesised that NTHi is able to reside intracellularly within COPD-derived airway epithelial cells (AEC), and that ...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S245819
更新日期:2020-06-04 00:00:00
abstract::Chronic obstructive pulmonary disease (COPD), a respiratory disease characterized by a progressive decline in lung function, is considered to be a leading cause of morbidity and mortality. Long-acting inhaled bronchodilators, such as long-acting β2 agonists (LABAs) or long-acting muscarinic antagonists (LAMAs), are th...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章,评审
doi:10.2147/COPD.S88246
更新日期:2015-10-30 00:00:00
abstract:PURPOSE:A low body mass index has been associated with high mortalities in patients with chronic obstructive pulmonary disease (COPD), and studies reveal that obesity aggravates the clinical effects of COPD. We investigated the impact of obesity on patients newly identified with COPD. PATIENTS AND METHODS:This populat...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S126192
更新日期:2017-02-24 00:00:00
abstract:BACKGROUND:Presence of chronic obstructive pulmonary disease (COPD) in heart failure (HF) has prognostic and therapeutic implications. Exact prevalence estimates are lacking because most previous studies estimated the prevalence of COPD among HF patients while unstable and in the presence of pulmonary congestion. METH...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S77085
更新日期:2015-06-26 00:00:00
abstract:PURPOSE:The purpose of this study was to define the prevalence of undiagnosed airflow obstruction (AO) among subjects with a history of smoking but no previous diagnosis of chronic lung disease. The finding of AO likely represents diagnosis of chronic obstructive pulmonary disease. PATIENTS:People aged ≥30 years with ...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章,多中心研究
doi:10.2147/COPD.S106306
更新日期:2016-09-27 00:00:00
abstract::[This corrects the article on p. 2749 in vol. 11, PMID: 27853362.]. ...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 已发布勘误
doi:10.2147/COPD.S130231
更新日期:2017-01-10 00:00:00
abstract::Pulmonary hypertension (PH) is the hemodynamic manifestation of various pathological processes that result in elevated pulmonary artery pressures (PAP). The National Institutes of Health Registry defined pulmonary arterial hypertension as the mean PAP of more than 25 mm Hg with a pulmonary capillary wedge pressure or ...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章,评审
doi:10.2147/copd.s5102
更新日期:2009-01-01 00:00:00
abstract:Objective:Chronic obstructive pulmonary disease (COPD) is associated with atherosclerosis. Previous studies including limited sample sizes have shown the prevalence of peripheral arterial occlusive disease (PAOD) among COPD patients. We sought to investigate the incidence of PAOD among COPD patients in Taiwan using a n...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S202029
更新日期:2019-07-04 00:00:00
abstract:BACKGROUND:To estimate the potential cost savings by following the current Global Initiative for Chronic Obstructive Lung Disease (GOLD) guideline recommendations in patients being treated for chronic obstructive pulmonary disease (COPD) with the combination of long-acting β(2)-agonist (LABA), long-acting muscarinic an...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S25805
更新日期:2012-01-01 00:00:00
abstract:PURPOSE:This study was conducted to determine COPD severity at the time of diagnosis as confirmed by spirometry in patients treated in a US managed care setting. PATIENTS AND METHODS:All patients with one or more inpatient stays, one or more emergency department visits, or two or more outpatient visits with diagnosis ...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S16975
更新日期:2011-01-01 00:00:00
abstract:Purpose:Chronic obstructive pulmonary disease (COPD) is a major cause of chronic diseases causing considerable social and economic burden globally. Despite substantial evidence on temperature-COPD association, few studies have investigated the acute effect of temperature variability (TV), a potential trigger of exacerb...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S260988
更新日期:2020-09-22 00:00:00
abstract:PURPOSE:COPD is characterized by an accelerated and progressive decline in forced expiratory volume in 1 second (FEV1) and lung hyperinflation. Although lung hyperinflation is the hallmark of COPD, data on the longitudinal changes in lung hyperinflation and any association with the decline in FEV1 are lacking. The aim ...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S122909
更新日期:2017-02-03 00:00:00
abstract::Chronic obstructive pulmonary disease (COPD) is a progressive chronic disease where treatment decisions should be based on disease severity and also should be equally distributed across age, gender, and social situation. The aim of this study was to determine to what extent patients with COPD are offered evidence-base...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S115238
更新日期:2016-10-26 00:00:00
abstract::Bronchodilators represent the hallmark of symptomatic treatment of Chronic Obstructive Pulmonary Disease (COPD). There are four categories of bronchodilators: anticholinergics, methylxanthines, short-acting beta2-agonists, and long-acting beta2-agonists such as formoterol. Significant research has been performed to in...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章,评审
doi:10.2147/copd.s1059
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:The hallmark of COPD is chronic airway inflammation, which may be mediated by renin-angiotensin system. The renin-angiotensin system blockers such as angiotensin-converting enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARBs) have exhibited anti-inflammatory and immunomodulatory effects in pa...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S104097
更新日期:2016-09-09 00:00:00
abstract:Background:The risk of dying of lung cancer is up to eightfold higher in patients with COPD than in age- and gender-matched controls. The aim of this study was to investigate the factors associated with lung cancer in a large cohort of COPD patients from primary care centers. Methods:To analyze whether age, gender, so...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S162484
更新日期:2018-06-06 00:00:00
abstract:BACKGROUND:The causal association between depression, anxiety, and health-related quality of life (HRQoL) in chronic obstructive pulmonary disease (COPD) is unclear. We therefore conducted a systematic review of prospective cohort studies that measured depression, anxiety, and HRQoL in COPD. METHODS:Electronic databas...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章,meta分析,评审
doi:10.2147/COPD.S58136
更新日期:2014-05-20 00:00:00
abstract:Objective:Our aim was to assess the impact of comorbidities on existing COPD prognosis scores. Patients and methods:A total of 543 patients with COPD (FEV1 <80% and FEV1/FVC <70%) were included between January 2003 and January 2004. Patients were stable for at least 6 weeks before inclusion and were followed for 5 yea...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S184695
更新日期:2019-03-07 00:00:00
abstract:Purpose:Education on the self-management of COPD has been shown to improve patients' quality of life and reduce hospital admissions. This study aimed to assess the feasibility of a pilot, pragmatic COPD Chronic Care (CCC) education program led by registered respiratory therapists and determine the CCC's impact on hospi...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章,随机对照试验
doi:10.2147/COPD.S154414
更新日期:2018-04-24 00:00:00
abstract:BACKGROUND AND OBJECTIVE:The overprescription of inhaled corticosteroids (ICS) in the current Global Initiative for Chronic Obstructive Lung Disease (GOLD) group A and B patients with chronic obstructive pulmonary disease (COPD) is not uncommon in clinical practice. The aim of this study was to explore the factors asso...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S88114
更新日期:2015-09-14 00:00:00
abstract:INTRODUCTION:Noninvasive ventilation (NIV) improves survival among patients with hypercapnic respiratory failure in hospital, but evidence for its use in domiciliary settings is limited. A patient's underlying risk of having an exacerbation may affect any potential benefit that can be gained from domiciliary NIV. This ...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章,meta分析,评审
doi:10.2147/COPD.S104238
更新日期:2016-09-16 00:00:00
abstract:Background:Airway inflammation may drive the progression of chronic obstructive pulmonary disease (COPD) associated with alpha-1 antitrypsin deficiency (AATD), but the relationship between airway microbiota and inflammation has not been investigated. Methods:We studied 21 non-treated AATD (AATD-noT) patients, 20 AATD-...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S207203
更新日期:2019-08-21 00:00:00
abstract::Pulmonary emphysema is usually the result of chronic exposure to cigarette smoke in at risk individuals. To investigate the hypothesis that lung damage in emphysema results from coincident weakening in the structural properties of the tissue and increased mechanical forces--as one explanation of the continued developm...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/copd.2007.2.1.81
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND:Circulating markers of inflammation in chronic obstructive pulmonary disease (COPD) may correlate to disease progression and extrapulmonary complications such as malnourishment. However, surprisingly little is known about gender-related differences for circulating inflammatory markers in COPD. PURPOSE:To ch...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S15351
更新日期:2011-01-01 00:00:00
abstract::Bronchoconstriction has been reported in asthma and chronic obstructive pulmonary disease (COPD) patients after administration of some aqueous inhalation solutions. We investigated the incidence of this event during long-term clinical trials of tiotropium delivered via Respimat(®) Soft Mist™ Inhaler (SMI). We retrospe...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S16094
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:This study was conducted in order to investigate the differences in the respiratory physiology of patients with chronic obstructive pulmonary disease (COPD), asthma-COPD overlap syndrome (ACOS), and asthma with airflow limitation (asthma FL(+)). METHODS:The medical records for a series of all stable patient...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S105988
更新日期:2016-05-09 00:00:00
abstract:BACKGROUND:The use of inhaled corticosteroids in patients with chronic obstructive pulmonary disease (COPD) has been associated with an increased risk of pneumonia in controlled clinical trials and case-control analyses. OBJECTIVE:Using claims databases as a research model of real-world diagnosis and treatment, to det...
journal_title:International journal of chronic obstructive pulmonary disease
pub_type: 杂志文章
doi:10.2147/COPD.S42366
更新日期:2013-01-01 00:00:00