Cost Analysis of Hospitalized Patients with Chronic Obstructive Pulmonary Disease: A State-Level CrossSectional Study

Authors

1 Department of Health Services Management, School of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran,

2 Social Determinants of health Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran,

3 Chronic Disease Care Research Center, Ahvaz Jundishapur University of Medical Sciences Ahvaz, Iran

4 Department of Biostatistics & Epidemiology, School of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran,

5 Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is a common disease with important healthcare, social, and economic consequences. The aim of this study was to analyze the costs of hospitalizing patients with COPD. Materials and Methods: In this state-level cross-sectional study, data from 165 COPD patients who had presented to our hospital between April 1, 2011 and March 31, 2013 were reviewed retrospectively. Patients were eligible for inclusion if they had a diagnosis of COPD [international classification of diseases-10 (ICD-10) code J44]. Costs of COPD patients were calculated by multiplying the amount of services used by the unit cost. Finally, we used multivariate regression analysis to determine predictors of hospital costs. Results: Mean (SD) age of the patients was 68.6 ± 12 years and 65.5% of them were ≥ 65. The mean (SD) and median length of stay (LOS) for patients were 8.5 ± 11.5 and five days [IQR 3; 9], respectively. All hospital cost drivers had significant relationships with LOS, and the mean cost per patient was higher in patients with hospital LOS longer than nine days. Prolonged LOS (LOS > 9 days) involved 830 bed/days. Therefore, the mean cost per each extra day of hospital stay was estimated to be US $115.80. The mean costs per patient with and without hypertension were US $1,422.5 and US $627.4, respectively (P=0.017). Conclusion: Hospitalization and medication costs were the two major cost drivers for patients hospitalized with COPD exacerbation. Duration of hospital stay, history of hypertension, and the number of clinical consultations other were significant predictors associated with hospital cost in patients with COPD.

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