A Study On Economic Burden For Hospitalized Patients With Copd

BackgroundAs the most common chronic respiratory disease, the morbidity, disability rate, mortality, and disease burden of chronic obstructive pulmonary disease (COPD), are increasing year by year. According to statistics, the number of patients with COPD in China is above 35 million. And COPD has posed great challenge to public health.The burden of COPD fully reflects its influence on society, families and patients. And the economic burden of disease includes two parts, direct burden and indirect burden. The direct economic burden refers to health-care costs, and the indirect economic burden stands for loss of production capacity and time as a result of disease. According to the information from the National heart, Lung, and Blood Institute (NHLBI), the economic burden of COPD in the United States in 1993 is 23.9 billion dollars, including 14.7 billion in direct medical expenses, 470 million dollars indirect economic burden and 4.5 billion dollars with premature death related expenses. Late-stage COPD needs long-term oxygen therapy and rehabilitation therapy, and may partly and totally cause self-care ability; therefore, it will bring a lot of family and social problems. There is no authority data in China at the present stage. In order to collect and perfect related data about economic burden of COPD, "Chronic Obstructive Pulmonary Disease Global Initiative" (GOLD) executive committee is planning on global burden of COPD research. Academician Zhong Nanshan and Professor Ran Pixin, as China's participation in the global research project leader and coordinator, has already started related research.This study comes from the Guangdong Province Natural Science Fund Project. We recognized that it is necessary for us to measure the total burden of disease and per capita burden of disease in a certain population, and then, take health interventions, and collaborative research. Therefore, we started from the economic burden of COPD study, in order to provide baseline data and quantitative analysis of findings for health policy makers.ObjectiveThis study explored the assessment of economic burden for hospitalized patients with COPD and its related factors in South China, aiming to provide baseline data and quantitative analysis for making health policies mitigating the economic burden of COPD.Materials and MethodsPatients admitted in Guangzhou Institute of Respiratory Disease (the First Affiliated Hospital of Guangzhou Medical College) in 2008 were collected as research samples. Related data was obtained from Medical Records and Statistics Management System of Guangzhou Institute of Respiratory Disease and medical records of hospitalized patients with COPD. Economic burden of COPD consists of two parts, direct and indirect economic burden. Direct economic burden of COPD stands for inpatient expenditure in 2008 and indirect economic burden is measured by human capital approach with the index of disability adjusted life years (DALY). Results1. The direct economic burden of 669 patients with COPD was $22,341.58 per case based on mean, and $12,666.57 based on median.2. The indirect economic burden of 669 patients with COPD was $40,503.02 per case based on mean, and $14,335.34 based on median.3. The economic burden of 669 patients with COPD was $62,844.60 per case based on mean, the proportion of direct economic burden and indirect economic burden was 35.55% and 64.45% respectively. And the economic burden of 669 patients with COPD was $29,915.73 per case based on median.Conclusions1. Marital status,mode of payment, hospital-stay length, operation treatment and origin of patients were main factors influencing the direct economic burden of COPD.2. Rational examination, medication and treatment, shortening hospital-stay length and tertiary prevention are effective ways to reduce the economic burden of COPD.