Economic analysis in admitted patients with acute exacerbation of chronic obstructive pulmonary disease

作     者：CHEN Ya-hong YAO Wan-zhen CAI Bai-qiang WANG Hong DENG Xiao-mei GAO Hui-li HUANG Jia-sheng WANG Xin-mao 

作者机构：Department of Respiratory Medicine Peking University ThirdHospital Beijing 100083 China Department of Respiratory Medicine Peking Union MedicalCollege Hospital Beijing 100730 China Department of Respiratory Medicine Sixth Peking HospitalBeijing 100007 China Department of Respiratory Medicine Beijing Haidian HospitalBeijing 100080 China 

出 版 物：《Chinese Medical Journal》 (中华医学杂志（英文版）)

年 卷 期：2008年第121卷第7期

页      面：587-591页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：chronic obstructive pulmonary disease acute exacerbation cost analysis 

摘      要：Background The socio-economic burden of acute exacerbation of chronic obstructive pulmonary disease （AECOPD） in Beijing is not fully understood. The study investigated the hospitalization cost in patients with AECOPD and the associated factors. Methods A multi-center, retrospective study was conducted in the four hospitals in Beijing including two level III hospitals and two level II hospitals. Patients with AECOPD admitted to the hospitals between January and December in 2006 were enrolled. The hospitalization cost and its relationship with disease severity and treatment were analyzed. Results Totally 439 patients were enrolled with 294 men （67.0%） and a mean age 73.4 years. The mean hospital stay was 20.7 days. A total of 204 patients （46.5%） had respiratory failure, 153 （34.9%） with cor pulmonale, 123 （28.0%） with coronary artery disease, 231 （52.6%） with hypertension, 70 （15.9%） with cerebrovascular disease and 32 （7.3%） with renal failure. The percentage of drug cost to total cost was the highest （71.2%）, followed by laboratory cost （16.7%）, therapy cost （9.7%）, oxygen cost （7.3%）, radiology cost （4.5%）, examination cost （4.5%）, bed cost （4.1%）. Correlation analysis showed that cost was positively correlated with age, hospitalization days, co-morbidities such as respiratory failure and cor pulmonale, hypertension. Three hundred and twenty-one patients were further analyzed. The hospitalization cost increased in patients with non-invasive ventilation （P〈0.01）, invasive mechanical ventilation （P〈0.01）, ICU stay （P〈0.01）, antibiotics （P〈0.05）, systemic steroids （P〈0.01）, and poor prognosis （P〈0.05）. Correlation analysis showed that the hospitalization cost was negatively correlated with percentage forced expiratory volume in 1 second （FEV1%） （r=-0.149, P〈0.05）, pH （r=-0.258, P〈0.01）, and PaO2 （r=-0.131, P〈0.05）, positively correlated with PaCO2 （r=0.319, P〈0.01）, non-invasive positive pressure ventilation （r=0.375, P〈0.01） and duration （r=0.463, P〈0.01）, invasive