Clinical and economic burden of dyspnea and other COPD symptoms in a managed care setting

Int J Chron Obstruct Pulmon Dis. 2017 Jul 4:12:1947-1959. doi: 10.2147/COPD.S134618. eCollection 2017.

Abstract

Purpose: The degree to which symptoms such as dyspnea affect patients with COPD is individualized. To address the gap between clinical symptom measures and self-perceived disease burden, we investigated the symptom status of adult patients with COPD and followed with an administrative claims analysis of health care resource utilization and costs.

Methods: This was a hybrid US observational study consisting of a cross-sectional patient survey followed by a retrospective analysis of administrative claims data. The primary COPD symptom measures were the modified Medical Research Council (mMRC) Dyspnea scale and the COPD Assessment Test (CAT).

Results: A total of 673 patients completed the survey. Of these, 65% reported mMRC grades 0-1 (low symptomatology) and 35% reported mMRC grades 2-4 (high symptomatology); 25% reported CAT score <10 (low symptomatology) and 75% reported CAT score ≥10 (high symptomatology). More patients with high symptomatology (by either measure) had at least one COPD-related inpatient hospitalization, emergency room visit, physician office visit, or other outpatient services, and filled at least one COPD-related prescription medication vs patients with low symptomatology. COPD-related costs were higher for patients with high symptomatology than patients with low symptomatology. In a multivariate analysis, COPD-related costs were also higher in patients reporting severe symptoms.

Conclusion: Patients with high COPD symptomatology utilized more health care resources and had higher COPD-related health care costs during the 6-month post-survey period than patients with low symptomatology.

Keywords: COPD; dyspnea; health care costs; health care resource utilization; health status; symptoms.

Publication types

  • Observational Study

MeSH terms

  • Administrative Claims, Healthcare
  • Adult
  • Aged
  • Ambulatory Care / economics
  • Chi-Square Distribution
  • Cross-Sectional Studies
  • Databases, Factual
  • Drug Costs
  • Dyspnea / diagnosis
  • Dyspnea / economics*
  • Dyspnea / physiopathology
  • Dyspnea / therapy*
  • Emergency Service, Hospital / economics
  • Female
  • Health Care Costs*
  • Health Care Surveys
  • Hospital Costs
  • Humans
  • Length of Stay / economics
  • Linear Models
  • Male
  • Managed Care Programs / economics*
  • Managed Care Programs / statistics & numerical data
  • Middle Aged
  • Multivariate Analysis
  • Office Visits / economics
  • Patient Admission / economics
  • Pulmonary Disease, Chronic Obstructive / diagnosis
  • Pulmonary Disease, Chronic Obstructive / economics*
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • Pulmonary Disease, Chronic Obstructive / therapy*
  • Retrospective Studies
  • Severity of Illness Index
  • Time Factors
  • Treatment Outcome
  • United States