Direct medical costs of chronic obstructive pulmonary disease: chronic bronchitis and emphysema.

Abstract:

:In this study we aimed to estimate direct medical costs of Chronic Obstructive Pulmonary Disease (COPD) by disease type; chronic bronchitis and emphysema. This study estimates direct costs in 1996 dollars using a prevalence approach and both aggregate and microcosting. A societal perspective is taken using prevalence, and multiple national, state and local data sources are used to estimate health-care utilization and costs. Chronic bronchitis and emphysema together account for $14.5 billion in annual direct costs. Inpatient costs are greater than outpatient and emergency costs ($8.3 vs. $7.8 billion) and hospital and medication costs account for most resources spent. The high prevalence of chronic bronchitis accounts for its larger total costs ($11.7 billion) compared with emphysema ($2.8 billion). Emphysema, which is more severe, has higher costs per prevalent case ($1341 vs. $816). Hospital stays account for the highest costs, $6.0 billion for chronic bronchitis and $1.9 billion for emphysema. The hospitalization rate, length of stay and average cost per prevalent case are higher for emphysema than for chronic bronchitis. Medication costs are the second highest cost category ($4.4 billion for chronic bronchitis, $0.693 billion for emphysema). The high hospitalization and low home care costs (0.2% of total) suggest underuse of home care and room to shift from acute to preventive care. More attention to healthcare management of chronic bronchitis and emphysema is suggested, and improving inhaler and anti-smoking compliance might be important targets.

journal_name

Respir Med

journal_title

Respiratory medicine

authors

Wilson L,Devine EB,So K

doi

10.1053/rmed.1999.0720

subject

Has Abstract

pub_date

2000-03-01 00:00:00

pages

204-13

issue

3

eissn

0954-6111

issn

1532-3064

pii

S0954-6111(99)90720-5

journal_volume

94

pub_type

杂志文章
  • Angiopoietin-2 expression in patients with an acute exacerbation of idiopathic interstitial pneumonias.

    abstract:BACKGROUND AND OBJECTIVE:We hypothesized that increased pulmonary vascular permeability may play a role in the pathogenesis of an acute exacerbation of the idiopathic interstitial pneumonias (AE-IIPs). Angiopoietin-2 (Ang-2) promotes endothelial activation, destabilization, and inflammation. The purpose of this study w...

    journal_title:Respiratory medicine

    pub_type: 杂志文章

    doi:10.1016/j.rmed.2016.05.012

    authors: Ando M,Miyazaki E,Abe T,Ehara C,Goto A,Masuda T,Nishio S,Fujisaki H,Yamasue M,Ishii T,Mukai Y,Ito T,Nureki SI,Kumamoto T,Kadota J

    更新日期:2016-08-01 00:00:00

  • An overview of nine clinical trials of salmeterol in an asthmatic population.

    abstract::In an attempt to establish the protection afforded by regular salmeterol use against induced bronchoconstriction in asthmatic patients, a meta-analysis was conducted on nine double-blind clinical trials that fulfilled the inclusion criteria. In each trial, subjects were randomly assigned to receive either salmeterol 5...

    journal_title:Respiratory medicine

    pub_type: 杂志文章,meta分析

    doi:10.1016/s0954-6111(98)90012-9

    authors: Verberne AA,Fuller R

    更新日期:1998-05-01 00:00:00

  • Cephalosporin-resistant pneumococcal pneumonia: does it, affect outcome?

    abstract:STUDY OBJECTIVES:Penicillin resistance has been reported in various studies to have no impact on the outcome of pneumococcal pneumonia. However, the importance of cephalosporin resistance has not been systematically studied. We conducted an analysis of patients with high-level cephalosporin-resistant Streptococcus pneu...

    journal_title:Respiratory medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1053/rmed.2002.1358

    authors: Ailani RK,Alimchandani A,Hidalgo J,Ailani R,Buckley J,DiGiovine B

    更新日期:2002-10-01 00:00:00

  • The prevalence of undiagnosed renal failure in a cohort of COPD patients in western Norway.

    abstract::Patients with COPD are at risk for other comorbid diseases, like heart failure, coronary heart disease, and depression. However, little is known about COPD phenotypes and prevalence of sub-clinical renal failure. 433 COPD patients and 233 subjects without COPD, from Western Norway, age 40-75, GOLD stage II-IV, were ex...

    journal_title:Respiratory medicine

    pub_type: 杂志文章

    doi:10.1016/j.rmed.2011.10.004

    authors: Gjerde B,Bakke PS,Ueland T,Hardie JA,Eagan TM

    更新日期:2012-03-01 00:00:00

  • Practical evaluation of asthma exacerbation self-management in children and adolescents.

    abstract::The objective of this study was to describe asthma exacerbation self-management in children and adolescents. We used a cross-sectional study population enrolled in the International Study of Asthma and Allergies in Childhood (ISAAC) in Bordeaux. Subjects answered an additional questionnaire on utilization of health se...

    journal_title:Respiratory medicine

    pub_type: 杂志文章

    doi:10.1053/rmed.2000.0888

    authors: Raherison C,Tunon-de-Lara JM,Vernejoux JM,Taytard A

    更新日期:2000-11-01 00:00:00

  • Long-term experience after transition from parenteral prostanoids to oral agents in patients with pulmonary hypertension.

    abstract:BACKGROUND:Long-term follow-up after transition to oral agents from parenteral prostanoid therapy has not been well characterized. METHODS:We reviewed our long-term experience after oral transitioning in patients with pulmonary hypertension. Patients were weaned off parenteral therapy based on a pre-determined outpati...

    journal_title:Respiratory medicine

    pub_type: 杂志文章

    doi:10.1016/j.rmed.2007.12.020

    authors: Diaz-Guzman E,Heresi GA,Dweik RA,Minai OA

    更新日期:2008-05-01 00:00:00

  • The relationship between the quality of prescribing and practice appointment rates with asthma management data in those admitted to hospital due to an acute exacerbation.

    abstract::Specific targeting of patients with a previous asthma hospitalisation could be more focused if predictors could be identified. This study was an observational retrospective analysis using ridge and linear multivariate regression analysis. Patient asthma management data were extracted from the hospital and general prac...

    journal_title:Respiratory medicine

    pub_type: 杂志文章

    doi:10.1016/j.rmed.2004.11.003

    authors: Salamzadeh J,Wong IC,Hosker HS,Patel MG,Chrystyn H

    更新日期:2005-06-01 00:00:00

  • Airway inflammation in obstructive sleep apnea: is leptin the missing link?

    abstract:BACKGROUND:Local and systemic inflammation is implicated in the pathophysiology of Obstructive Sleep Apnea (OSA). Exhaled breath condensate (EBC) is a non-invasive sampling method for the lower airways. However, it is important to consider the potential effect of the systemic origin whereas systemic inflammation is sig...

    journal_title:Respiratory medicine

    pub_type: 杂志文章

    doi:10.1016/j.rmed.2008.04.021

    authors: Antonopoulou S,Loukides S,Papatheodorou G,Roussos C,Alchanatis M

    更新日期:2008-10-01 00:00:00

  • Inspired fraction of carbon dioxide in oxygen supply to chronic pulmonary disease.

    abstract::Hypoxemic patients with chronic obstructive pulmonary disease (COPD) are at risk of carbon dioxide (CO(2)) retention during oxygen therapy and hypercapnia in COPD is associated with an ominous prognosis. Rebreathing with oxygen mask is possible in practice and possibly affects CO(2) retention due to an increased inspi...

    journal_title:Respiratory medicine

    pub_type: 杂志文章

    doi:10.1016/j.rmed.2008.08.015

    authors: Fremault A,Silva M,Beaucage F,Berckmans D,Decramer M

    更新日期:2008-12-01 00:00:00

  • Increased levels of prostaglandin E-major urinary metabolite (PGE-MUM) in chronic fibrosing interstitial pneumonia.

    abstract:BACKGROUND:Dysregulation of the prostaglandin E2 (PGE2) signaling pathway has been implicated in interstitial pneumonia (IP) pathogenesis. Due to the unstable nature of PGE2, available detection methods may not precisely reflect PGE2 levels. We explored the clinical usefulness of measuring stable prostaglandin E-major ...

    journal_title:Respiratory medicine

    pub_type: 杂志文章

    doi:10.1016/j.rmed.2016.11.017

    authors: Horikiri T,Hara H,Saito N,Araya J,Takasaka N,Utsumi H,Yanagisawa H,Hashimoto M,Yoshii Y,Wakui H,Minagawa S,Ishikawa T,Shimizu K,Numata T,Arihiro S,Kaneko Y,Nakayama K,Matsuura T,Matsuura M,Fujiwara M,Okayasu I,I

    更新日期:2017-01-01 00:00:00

  • Exhaled nitric oxide: independent effects of atopy, smoking, respiratory tract infection, gender and height.

    abstract::Measurement of exhaled nitric oxide is widely used in respiratory research and clinical practice, especially in patients with asthma. However, interpretation is often difficult, due to common interfering factors, and little is known about interactions between factors. We assessed the influences and interactions of fac...

    journal_title:Respiratory medicine

    pub_type: 杂志文章

    doi:10.1016/j.rmed.2008.02.012

    authors: Dressel H,de la Motte D,Reichert J,Ochmann U,Petru R,Angerer P,Holz O,Nowak D,Jörres RA

    更新日期:2008-07-01 00:00:00

  • Long term haemodynamic, pulmonary function and symptomatic effects of pirbuterol in COPD.

    abstract::Haemodynamic studies at rest and during exercise together with radionuclide ventriculography, pulmonary function and clinical well-being assessment were evaluated in ten patients with COPD and secondary pulmonary hypertension (mean PAP 25 mm Hg), before and after 6 months therapy with pirbuterol 20 mg thrice daily. De...

    journal_title:Respiratory medicine

    pub_type: 临床试验,杂志文章

    doi:10.1016/s0954-6111(89)80061-7

    authors: Neilly JB,Carter R,Tweddel A,Martin W,Hutton I,Banham SW,Stevenson RD

    更新日期:1989-01-01 00:00:00

  • Lung function abnormalities in children with type I diabetes.

    abstract::Recent developments in intrabronchial administration of insulin raise lung function in patients with type I diabetes as important issue. Several studies in adults report abnormalities of lung function of these patients. The aim of this study was to investigate lung function in children with type I diabetes. Twenty-sev...

    journal_title:Respiratory medicine

    pub_type: 杂志文章

    doi:10.1053/rmed.2002.1402

    authors: van Gent R,Brackel HJ,de Vroede M,van der Ent CK

    更新日期:2002-12-01 00:00:00

  • Clinical audit of subjects with snoring & sleep apnoea/hypopnoea syndrome fitted with mandibular repositioning splint.

    abstract::Snoring and obstructive sleep apnoea/hypopnoea syndrome (OSAHS) are often treated with mandibular repositioning splints (MRS), but the efficacy and satisfaction of them has not been comprehensively addressed. A survey on the use of and satisfaction with MRS was posted to 177 patients referred by a hospital orthodontic...

    journal_title:Respiratory medicine

    pub_type: 杂志文章

    doi:10.1016/j.rmed.2004.07.007

    authors: Izci B,McDonald JP,Coleman EL,Mackay TW,Douglas NJ,Engleman HM

    更新日期:2005-03-01 00:00:00

  • Lack of association between KIR and HLA-C type and susceptibility to idiopathic bronchiectasis.

    abstract:INTRODUCTION:Idiopathic bronchiectasis is a poorly defined disease characterised by persistent inflammation, infection and progressive lung damage. Natural killer (NK) cells provide a major defense against infection, through the interaction of their surface receptors, including the activating and inhibitory killer immu...

    journal_title:Respiratory medicine

    pub_type: 杂志文章

    doi:10.1016/j.rmed.2014.05.017

    authors: McDonnell MJ,Anwar GA,Rutherford RM,De Soyza A,Worthy S,Corris PA,Lordan JL,Bourke S,Afolabi G,Ward C,Middleton P,Middleton D

    更新日期:2014-08-01 00:00:00

  • Persistence with inhaled corticosteroid therapy in daily practice.

    abstract:OBJECTIVE:To quantify persistence with inhaled corticosteroids (ICS) among new users in daily practice and identify determinants of persistence. METHODS:A retrospective cohort study was performed with data from the Dutch PHARMO system. This system consists of medication and hospital admission records of 325,000 inhabi...

    journal_title:Respiratory medicine

    pub_type: 杂志文章

    doi:10.1016/j.rmed.2004.01.014

    authors: Breekveldt-Postma NS,Gerrits CM,Lammers JW,Raaijmakers JA,Herings RM

    更新日期:2004-08-01 00:00:00

  • Single breath N2-test and exhaled nitric oxide in men.

    abstract::The N(2) slope is an index of inhomogeneous distribution of ventilation and has been suggested to be suited for early testing of chronic obstructive pulmonary disease (COPD) in smokers. The aim of the present study was to examine the association between the fraction of exhaled nitric oxide (FENO) and the N(2) slope in...

    journal_title:Respiratory medicine

    pub_type: 杂志文章

    doi:10.1016/j.rmed.2005.09.037

    authors: Olin AC,Andelid K,Vikgren J,Rosengren A,Larsson S,Bake B,Ekberg-Jansson A

    更新日期:2006-06-01 00:00:00

  • Population-based estimates of transbronchial lung biopsy utilization and complications.

    abstract:BACKGROUND:Little is known about trends in the utilization or complication rates of transbronchial lung biopsy, particularly in community hospitals. METHODS:We used the Healthcare Cost and Utilization Project Florida State Inpatient and State Ambulatory Surgical Databases to assess trends in transbronchial lung biopsy...

    journal_title:Respiratory medicine

    pub_type: 杂志文章

    doi:10.1016/j.rmed.2012.08.008

    authors: Tukey MH,Wiener RS

    更新日期:2012-11-01 00:00:00

  • Functional associations of pleuroparenchymal fibroelastosis and emphysema with hypersensitivity pneumonitis.

    abstract:BACKGROUND:Pleuroparenchymal fibroelastosis (PPFE) has been described in hypersensitivity pneumonitis (HP) yet its functional implications are unclear. Combined pulmonary fibrosis and emphysema (CPFE) has occasionally been described in never-smokers with HP, but epidemiological data regarding its prevalence is sparse. ...

    journal_title:Respiratory medicine

    pub_type: 杂志文章

    doi:10.1016/j.rmed.2018.03.031

    authors: Jacob J,Odink A,Brun AL,Macaluso C,de Lauretis A,Kokosi M,Devaraj A,Desai S,Renzoni E,Wells AU

    更新日期:2018-05-01 00:00:00

  • Sleep related respiratory events during non-invasive ventilation of patients with chronic hypoventilation.

    abstract:BACKGROUND:Non-invasive ventilation (NIV) is increasingly used in the treatment of patients with chronic hypercapnic respiratory failure (CRF). Residual sleep related respiratory events under NIV such as obstructive or central apnea/hypopnea (AH), or patient-ventilator asynchrony (PVA), may compromise treatment efficac...

    journal_title:Respiratory medicine

    pub_type: 杂志文章

    doi:10.1016/j.rmed.2017.10.025

    authors: Aarrestad S,Qvarfort M,Kleiven AL,Tollefsen E,Skjønsberg OH,Janssens JP

    更新日期:2017-11-01 00:00:00

  • Resting and ADL-induced dynamic hyperinflation explain physical inactivity in COPD better than FEV1.

    abstract:BACKGROUND:Physical activity and health status deteriorate early in the course of chronic obstructive pulmonary disease (COPD). This can only partially be explained by the degree of airflow limitation. Changes in (resting and dynamic) lung volumes are known to be associated with functional impairments and thus might in...

    journal_title:Respiratory medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1016/j.rmed.2013.02.017

    authors: Lahaije AJ,van Helvoort HA,Dekhuijzen PN,Vercoulen JH,Heijdra YF

    更新日期:2013-06-01 00:00:00

  • Depression and its relationship with poor exercise capacity, BODE index and muscle wasting in COPD.

    abstract:BACKGROUND:The prevalence of depression in stable COPD patients varies markedly, possibly because of use of different scales. We aimed to assess depression using 2 different depression scales and to examine the association between depression and poor exercise performance, BODE index and muscle wasting in clinically sta...

    journal_title:Respiratory medicine

    pub_type: 杂志文章

    doi:10.1016/j.rmed.2008.11.021

    authors: Al-shair K,Dockry R,Mallia-Milanes B,Kolsum U,Singh D,Vestbo J

    更新日期:2009-10-01 00:00:00

  • Long-term prognosis of immediate hypersensitivity type of occupational laryngitis.

    abstract::The present study investigated, for the first time, the long-term prognosis of hypersensitivity type of occupational laryngitis (OL). Thirteen patients with OL diagnosed in 1990-1993 at the Finnish Institute of Occupational Health participated in a questionnaire follow-up study. The records of the primary diagnostic i...

    journal_title:Respiratory medicine

    pub_type: 杂志文章

    doi:10.1016/j.rmed.2008.07.015

    authors: Hannu T,Sala E,Toskala E

    更新日期:2009-01-01 00:00:00

  • Artificial pneumothorax by the Veress cannula: efficacy and safety.

    abstract::In 16 patients with pulmonary fibrosis, an artificial pneumothorax was introduced using the Veress cannula and the Saugman water manometer. Atmospheric air was introduced by fractionated insufflation to a total volume of 800 ml (median). The interpleural space was found on the first attempt, and in all cases, fraction...

    journal_title:Respiratory medicine

    pub_type: 临床试验,杂志文章

    doi:10.1016/s0954-6111(97)90253-5

    authors: Faurschou P,Viskum K

    更新日期:1997-08-01 00:00:00

  • The prevalence of preferential nasal breathing in adults.

    abstract::The prevalence of preferential nasal breathing was studied in an awake adult population. One hundred and ninety-four people consented to gentle manual compression of the nostrils. They were advised to 'breathe in and out', but no further information regarding breathing was given to avoid influencing the patient. One h...

    journal_title:Respiratory medicine

    pub_type: 杂志文章

    doi:10.1016/0954-6111(93)90026-v

    authors: Ward KA,Nicholls DP,Stanford CF

    更新日期:1993-05-01 00:00:00

  • Changes in airway hyperresponsiveness following smoking cessation: comparisons between Mch and AMP.

    abstract:BACKGROUND:Given the observed association between smoking, inflammation and airway hyperresponsiveness (AHR) one may predict that smoking cessation may improve AHR. However, only a few studies have investigated the effect of smoking on AHR and their results appear to be conflicting depending on the stimulus used in the...

    journal_title:Respiratory medicine

    pub_type: 杂志文章

    doi:10.1016/j.rmed.2007.09.004

    authors: Piccillo G,Caponnetto P,Barton S,Russo C,Origlio A,Bonaccorsi A,Di Maria A,Oliveri C,Polosa R

    更新日期:2008-02-01 00:00:00

  • Prevalence and impact of respiratory symptoms in a population of patients with COPD in Latin America: The LASSYC observational study.

    abstract:BACKGROUND:To analyse the relationship between symptoms at different times during the 24-hour day and outcomes in COPD. METHODS:Observational cross-sectional study in a patients from 7 Latin American countries. The frequency of symptoms in the morning, at night and during the day was explored by means of standardised ...

    journal_title:Respiratory medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1016/j.rmed.2017.11.018

    authors: Miravitlles M,Menezes A,López Varela MV,Casas A,Ugalde L,Ramirez-Venegas A,Mendoza L,López A,Wehrmeister FC,Surmont F,Montes de Oca M

    更新日期:2018-01-01 00:00:00

  • The natural history of non-cavitary nodular bronchiectatic Mycobacterium avium complex lung disease.

    abstract:PURPOSE:We aimed to investigate the natural history of non-cavitary nodular bronchiectatic (NC-NB) Mycobacterium avium complex (MAC) lung disease (LD). METHODS:Among all patients diagnosed with NC-NB MAC LD between March 2000 and December 2013, 551 patients who were followed until December 2017 were enrolled at a tert...

    journal_title:Respiratory medicine

    pub_type: 杂志文章

    doi:10.1016/j.rmed.2019.02.007

    authors: Kwon BS,Lee JH,Koh Y,Kim WS,Song JW,Oh YM,Lee SD,Lee SW,Lee JS,Lim CM,Choi CM,Huh JW,Hong SB,Shim TS,Jo KW

    更新日期:2019-04-01 00:00:00

  • Eosinophilic airway inflammation as an underlying mechanism of undiagnosed prolonged cough in primary healthcare patients.

    abstract::Prolonged cough is a common problem in patients seen in general practice. Using a simple method of sputum induction and processing of sputum samples, we determined whether eosinophilic airway inflammation could be a cause of undiagnosed prolonged cough. Eighty-two patients who had had cough for more than 1 month were ...

    journal_title:Respiratory medicine

    pub_type: 杂志文章

    doi:10.1053/rmed.2001.1215

    authors: Rytilä P,Metso T,Petäys T,Sohlman A,Työlahti H,Kohonen-Jalonen P,Kiviniemi P,Haahtela T

    更新日期:2002-01-01 00:00:00

  • Once-weekly azithromycin in cystic fibrosis with chronic Pseudomonas aeruginosa infection.

    abstract:BACKGROUND:Data on the effects of long-term treatment with azithromycin (AZM) on inflammatory markers in cystic fibrosis patients chronically infected with Pseudomonas aeruginosa are scarce. So far there is no pharmacokinetic and clinical data on once-weekly dosage of AZM in CF patients. METHODS:In a randomised double...

    journal_title:Respiratory medicine

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1016/j.rmed.2008.03.009

    authors: Steinkamp G,Schmitt-Grohe S,Döring G,Staab D,Pfründer D,Beck G,Schubert R,Zielen S

    更新日期:2008-11-01 00:00:00