Effect of the economic crisis on the use of health and home care services among Spanish COPD patients

• Published in: International journal of chronic obstructive pulmonary disease 2018-01, Vol.13, p.725-739
• Main Authors: de Miguel-Diez, Javier, Lopez-de-Andres, Ana, Herandez-Barrera, Valentin, Jimenez-Trujillo, Isabel, Puente-Maestu, Luis, Cerezo-Lajas, Alicia, Jimenez-Garcia, Rodrigo
• Format: Article
• Language: English
• Subjects: Adult; Aged; Ambulatory Care - economics; Analysis; Chronic illnesses; Chronic obstructive lung disease; Chronic obstructive pulmonary disease; Comorbidity; COPD; Cross-Sectional Studies; Death; Economic aspects; Economic crisis; Economic Recession - trends; Exercise; Female; Financial crises; General practitioners; Health Care Costs - trends; Health Care Surveys; Health Resources - economics; Health Resources - trends; Health Resources - utilization; healthcare services; Home care; Home care services; Home Care Services - economics; Home Care Services - trends; Home Care Services - utilization; Home health care; Hospital Costs; Hospitalization; Humans; Interviews; Lifestyles; Lung diseases; Male; Medical care utilization; Mental disorders; Middle Aged; Nursing; Nursing Services - economics; Office Visits - economics; Original Research; population-based; Prevalence; Public access; Pulmonary Disease, Chronic Obstructive - diagnosis; Pulmonary Disease, Chronic Obstructive - economics; Pulmonary Disease, Chronic Obstructive - epidemiology; Pulmonary Disease, Chronic Obstructive - rehabilitation; Sex Factors; Spain - epidemiology; survey; Surveys; Time Factors; time trends; Trends; Variables; Womens health
• ISSN: 1178-2005; 1176-9106; 1178-2005
• DOI: 10.2147/COPD.S150308

Chronic obstructive pulmonary disease (COPD) is a major cause of disability and death worldwide. Consequently, COPD patients are frequent users of health and social resources. Therefore, they are highly vulnerable to decreases in investment in healthcare services. We aimed to describe the utilization of health and home care services among Spanish COPD patients during the economic crisis to identify factors independently associated with changes in the utilization of these services and to study the time trends from 2009 to 2014. We used data from the European Health Interview Surveys for Spain (EHSS) conducted between 2009/2010 (n=22,188) and 2014 (n=22,842). We included responses from adults with COPD aged 40 years or over. Dependent variables included self-reported hospitalizations during the previous year, general practitioner (GP) visits during the last 4 weeks, other health care services used during the previous year (nursing, rehabilitation, and psychological services), and home care services use during the previous year. Independent variables included demographic and socioeconomic characteristics, health status variables, and lifestyles. We identified 1,328 and 1,008 COPD patients from EHSS 2009 and EHSS 2014, respectively. We observed a significant increase in non-GP services use (30.6% in 2009 vs 39.11% in 2014;