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 Medjournal_title
Respiratory medicineauthors
Wilson L,Devine EB,So Kdoi
10.1053/rmed.1999.0720subject
Has Abstractpub_date
2000-03-01 00:00:00pages
204-13issue
3eissn
0954-6111issn
1532-3064pii
S0954-6111(99)90720-5journal_volume
94pub_type
杂志文章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
更新日期:2016-08-01 00:00:00
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
更新日期:1998-05-01 00:00:00
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
更新日期:2002-10-01 00:00:00
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
更新日期:2012-03-01 00:00:00
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
更新日期:2000-11-01 00:00:00
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
更新日期:2008-05-01 00:00:00
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
更新日期:2005-06-01 00:00:00
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
更新日期:2008-10-01 00:00:00
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
更新日期:2008-12-01 00:00:00
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
更新日期:2017-01-01 00:00:00
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
更新日期:2008-07-01 00:00:00
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
更新日期:1989-01-01 00:00:00
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
更新日期:2002-12-01 00:00:00
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
更新日期:2005-03-01 00:00:00
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
更新日期:2014-08-01 00:00:00
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
更新日期:2004-08-01 00:00:00
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
更新日期:2006-06-01 00:00:00
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
更新日期:2012-11-01 00:00:00
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
更新日期:2018-05-01 00:00:00
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
更新日期:2017-11-01 00:00:00
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
更新日期:2013-06-01 00:00:00
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
更新日期:2009-10-01 00:00:00
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
更新日期:2009-01-01 00:00:00
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
更新日期:1997-08-01 00:00:00
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
更新日期:1993-05-01 00:00:00
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
更新日期:2008-02-01 00:00:00
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
更新日期:2018-01-01 00:00:00
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
更新日期:2019-04-01 00:00:00
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
更新日期:2002-01-01 00:00:00
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
更新日期:2008-11-01 00:00:00