Comparative study on medical utilization and costs of chronic obstructive pulmonary disease with good lung function

• Published in: International journal of chronic obstructive pulmonary disease 2017-01, Vol.12, p.2711-2721
• Main Authors: Lim, Jeong Uk, Kim, Kyungjoo, Kim, Sang Hyun, Lee, Myung Goo, Lee, Sang Yeub, Yoo, Kwang Ha, Lee, Sang Haak, Jung, Ki-Suck, Rhee, Chin Kook, Hwang, Yong Il
• Format: Article
• Language: English
• Subjects: Adrenergic beta-2 Receptor Agonists - economics; Adrenergic beta-2 Receptor Agonists - therapeutic use; Adult; Aged; Aged, 80 and over; Airway management; Ambulatory Care - economics; Asymptomatic Diseases; Bronchodilator Agents - economics; Bronchodilator Agents - therapeutic use; Care and treatment; Chronic obstructive lung disease; Chronic obstructive pulmonary disease; Comparative analysis; Costs; Drug Costs; Dyspnea; Early COPD; Economic aspects; Ethics; Female; Forced Expiratory Volume; Foreign exchange rates; Health Care Costs; Health insurance; Health Resources - economics; Health Resources - utilization; Health Services Misuse - economics; Hospital Costs; Hospitals; Humans; Lung - drug effects; Lung - physiopathology; Male; Medical care utilization; Medical cost; Medical research; Medical utilization; Middle Aged; Mortality; Muscarinic Antagonists - economics; Muscarinic Antagonists - therapeutic use; Nutrition; Nutrition Surveys; Original Research; Patients; Process Assessment (Health Care) - economics; Pulmonary Disease, Chronic Obstructive - diagnosis; Pulmonary Disease, Chronic Obstructive - economics; Pulmonary Disease, Chronic Obstructive - physiopathology; Pulmonary Disease, Chronic Obstructive - therapy; Quality of Life; Questionnaires; Republic of Korea; Retrospective Studies; Surveys and Questionnaires; Time Factors; Treatment Outcome
• ISSN: 1178-2005; 1176-9106; 1178-2005
• DOI: 10.2147/COPD.S143244

Patients with mild to moderate chronic obstructive pulmonary disease (COPD) are underdiagnosed and undertreated due to the asymptomatic nature of the disease. Previous studies on patients with mild COPD have focused on symptomatic patients. Therefore, in this study, we evaluated the treatment status of patients with early COPD in Korea. We compared hospital visits, medical costs per person, and COPD medication use by patients with COPD screened from the general population and COPD cohort patients. Patients with COPD aged ≥40 years with the value of forced expiratory volume in 1 s (FEV ) ≥60% were selected from the 2007 to 2012 Korea National Health and Nutrition Examination Survey (KNHANES) data. Data including the number of outpatient clinic visits, admission to hospitals, COPD-related medications, and medical costs were obtained from the Health Insurance Review and Assessment Service and were compared with the data of patients with COPD with FEV ≥60% from the Korean COPD Subtype Study (KOCOSS) cohort. Based on EuroQol 5-dimension questionnaire index scores of 0.9±0.14, we found that patients with COPD from the KNHANES group showed few symptoms compared to those from the KOCOSS cohort. In 2007, among the patients with COPD with an FEV value of ≥60%, only 3.6% from the KNHANES group and 30% from the KOCOSS cohort visited medical facilities. Total medical cost per person per year increased from 264.37±663.41 US Dollars (USD) in 2007 to 797.00±2,724.21 USD in 2012 for the KNHANES group. In 2012, only 20.7% of the patients from KNHANES database received long-acting muscarinic agonists (LAMA), whereas 78.7% of the patients from KOCOSS database received LAMA. Medical resource utilization and medical costs per person for patients with early COPD in Korea increased. However, asymptomatic patients with COPD represented by the KNHANES group do not receive adequate long-term treatment compared to relatively symptomatic patients, and require more clinical attention from physicians.