The Effect of Quitting Smoking on Costs and Healthcare Utilization in Patients with Chronic Obstructive Pulmonary Disease: A Comparison of Current Smokers Versus Ex-Smokers in Routine Clinical Practice

• Published in: Lung 2014-08, Vol.192 (4), p.505-518
• Main Authors: Sicras-Mainar, Antoni, Rejas-Gutiérrez, Javier, Navarro-Artieda, Ruth, Ibáñez-Nolla, Jordi
• Format: Article
• Language: English
• Subjects: Absenteeism; Adult; Aged; Aged, 80 and over; Care and treatment; Chronic obstructive pulmonary disease; Comorbidity; Complications and side effects; Demographic aspects; Drug Costs; Efficiency; Female; Health aspects; Health Care Costs; Health care expenditures; Health Resources - economics; Health Resources - utilization; Health services utilization; Humans; Lung diseases, Obstructive; Male; Medical care; Medicine; Medicine & Public Health; Middle Aged; National Health Programs - economics; National Health Programs - utilization; Office Visits - economics; Office Visits - utilization; Pneumology/Respiratory System; Pulmonary Disease, Chronic Obstructive - diagnosis; Pulmonary Disease, Chronic Obstructive - economics; Pulmonary Disease, Chronic Obstructive - etiology; Pulmonary Disease, Chronic Obstructive - therapy; Retrospective Studies; Risk Factors; Sick Leave - economics; Smoking - adverse effects; Smoking - economics; Smoking cessation; Smoking Cessation - economics; Smoking cessation programs; Smoking Prevention; Spain; Treatment Outcome; Utilization
• ISSN: 0341-2040; 1432-1750
• DOI: 10.1007/s00408-014-9592-7

Purpose Chronic obstructive pulmonary disease (COPD) is a prevalent condition mainly related to smoking, which is associated with a substantial economic burden. The purpose was to compare healthcare resource utilization and costs according to smoking status in patients with COPD in routine clinical practice. Methods A retrospective cohort nested case–control study was designed. The cohort was composed of male and female COPD outpatients, 40 years or older, covered by the Badalona Serveis Assistencials (a health provider) health plan. Cases were current smokers with COPD and controls (two per case) were former smokers with COPD (at least 12 months without smoking), matched for age, sex, duration of COPD, and burden of comorbidity. The index date was the last visit recorded in the database, and the analysis was performed retrospectively on healthcare resource utilization data for the 12 months before the index date. Results A total of 930 COPD records were analyzed: 310 current and 620 former smokers [mean age 69.4 years (84.6 % male)]. Cases had more exacerbations, physician visits of any type, and drug therapies related to COPD were more common. As a consequence, current smokers had higher average annual healthcare costs: €3,784 (1,888) versus €2,302 (2,451), p