The DOSE index in chronic obstructive pulmonary disease: evaluating healthcare costs

• Published in: BMC pulmonary medicine 2024-11, Vol.24 (1), p.560-8, Article 560
• Main Authors: Li, Chin-Ling, Chang, Hui-Chuan, Tseng, Ching-Wan, Tsai, Yuh-Chyn, Liu, Jui-Fang, Chan, Chia-Chuan, Tsai, Meng-Lin, Liu, Shih-Feng
• Format: Article
• Language: English
• Subjects: ADO index; Aged; BODE index; Body Mass Index; Chronic obstructive pulmonary disease; Comorbidity; COPD; Costs; Cross-Sectional Studies; Development and progression; Disease Progression; DOSE index; Dyspnea; Dyspnea - economics; Emergency medical care; Evaluation; Female; Health care; Health Care Costs - statistics & numerical data; Health care expenditures; Hospitalization; Hospitalization - economics; Hospitals; Humans; Lung diseases; Lung diseases, Obstructive; Male; Medical care, Cost of; Medical cost; Medical research; Middle Aged; Patients; Prognosis; Pulmonary Disease, Chronic Obstructive - economics; Respiration; Retrospective Studies; Review boards; Risk Assessment; Risk factors; Severity of Illness Index; Smoking - epidemiology; Variance analysis
• ISSN: 1471-2466; 1471-2466
• DOI: 10.1186/s12890-024-03368-0

The DOSE index, which incorporates Dyspnea, Obstruction, Smoking, and Exacerbations, is a widely used tool for assessing the severity and prognosis of Chronic Obstructive Pulmonary Disease (COPD). In addition to risk assessment, it has potential clinical utility in predicting healthcare costs, which are primarily driven by exacerbations. While several indices, such as the BODE (Body-mass index, Obstruction, Dyspnea, Exercise) and ADO (Age, Dyspnea, Obstruction) indices, exist for risk prediction, there is a lack of dedicated tools for forecasting healthcare costs. This study explores the potential of the DOSE index compared to other indices, including BODE, ADO, and the Charlson Comorbidity Index (CCI), for this purpose. This cross-sectional retrospective study analyzed data from 396 COPD cases. We examined associations between the DOSE index, BODE index, ADO index, CCI, and healthcare costs, including hospitalizations and emergency room treatments. Healthcare costs were categorized as direct medical expenses. Significant associations were observed between the DOSE index and various healthcare parameters. DOSE quartiles showed strong correlations with outpatient visits (p = 0.013) and outpatient medical expenses (p = 0.011). In addition, hospitalization frequency, duration, and associated costs were significantly correlated with higher DOSE quartiles (p