Healthcare Service Usage and Costs for Elderly Patients with Obstructive Lung Disease

Figures & data

Table 1 Characteristics of the Study Sample with Obstructive Lung Disease

Patients with BPCO			37,915
Sex	% (n)	Female	54.55% (20,684)
	% (n)	Male	45.45% (17,231)
Age	mean (±SD)		77.29 (±8,1)
RUB	% (n)	1	77.33% (8.05)
	% (n)	2	11.58% (4389)
	% (n)	3	17.61% (6675)
	% (n)	4	47.58% (18,040)
	% (n)	5	14.43% (5470)
Cancer	% (n)		14.88% (5641)
Arhythmia	% (n)		19.35% (7338)
Cerebrovascular Disease	% (n)		9.69% (3673)
Dementia and delirium	% (n)		6.32% (2398)
Diabetes mellitus	% (n)		19.41% (7358)
Lipid Metabolism disorders	% (n)		37.82% (14,341)
Hypothyroidism	% (n)		7.35% (2787)
Chronic kidney failure	% (n)		4.05% (1537)
Hypertension	% (n)		76.45% (28,986)
Congestive heart failure	% (n)		30.47% (11,553)
Ischemic heart disease	% (n)		13.88% (5262)
Depression	% (n)		18.38% (6967)
Parkinson’s Disease	% (n)		3.01% (1143)
Rheumatoid arthritis	% (n)		1.79% (680)
Osteoporosis	% (n)		36.86% (13,974)
Total Costs	mean (±SD)		4261.20 (8155.30)
Pharmacy Costs	mean (±SD)		1099.14 (3555.51)
Emergency department visits, No.	mean (±SD)		0.51 (1.08)
Outpatient visits, No.	mean (±SD)		9.57 (10.61)
Hospital admissions, No.	mean (±SD)		0.39 (0.86)

Table 2 Distribution of Healthcare Resource Usage, Costs and Death Rate by Comorbidity Class

No. of Chronic Disorders in Addition to Obstructive Lung Disease		0	1	2	3	4	5	6+	Total	Association with Comorbidity Class p-value
No. of patients in class		2681	6315	7714	7485	5804	3949	3967	37,915
Sex	Female % (n)	42.9% (1150)	51.3% (3238)	58.5% (4511)	56.5% (4231)	56.7% (3294)	55.2% (2178)	52.5% (2082)	54.5% (20,684)	<0.05 *
	Male % (n)	57.1% (1531)	48.7% (3077)	41.5% (3203)	43.5% (3254)	43.2% (2510)	44.8% (1771)	47.5% (1885)	45.4% (17,231)
Age	Mean	72.45	74.40	76.12	77.51	79.09	80.43	81.63	77.33	<0.01 ***
	Median	71	73	75	77	79	81	82	77
	(IQR)	9	11	11	12	12	11	10	12
Total costs	Mean	1158.84	1982.26	2888.20	3796.08	5242.76	6702.69	9666.60	4261.20	<0.01***
	Median	464.83	737.93	1092.19	1535.78	2195.831	3420.23	5655.97	1526.07
	(IQR)	865	1144	1671	2569	4129	6162	9487	3322
Pharmacy costs	Mean	330.23	531.97	826.39	1101.97	1388.68	1707.61	2017.39	1099.14	<0.01 ***
	Median	136.06	293.13	446.34	636.11	845.8	1070	1272.41	599.53
	(IQR)	363	459	590	750	916	1072	1283	875
Emergency department visits, No.	Mean	0.27	0.33	0.40	0.49	0.59	0.71	0.87	0.51	<0.01 ***
	Median	0	0	0	0	0	0	0	0
	(IQR)	0	0	1	1	1	1	1	1
Outpatient visits, No.	Mean	4.45	6.20	7.97	9.62	11.39	12.78	15.54	9.57	<0.01 ***
	Median	3	4	6	7	9	10	11	7
	(IQR)	5	6	8	9	11	12	14	10
Hospital admissions, No.	Mean	0.09	0.14	0.22	0.30	0.47	0.68	1.09	0.39	<0.01 **
	Median	0	0	0	0	0	0	1	0
	(IQR)	0	0	0	0	1	1	2	0
Crude death rate		1.36%	1.89%	3.39%	4.91%	7.88%	12.14%	18.61%	6.24%	<0.01 *

Notes: *Chi-squared test. **Kruskal–Wallis test. ***Friedman test.

Table 3 Regression Analyses Between Dependent Variables (Healthcare Cost and Service Usage, and Mortality) and Comorbidity Class, Adjusted for Sex and Age

Total Costs, GLM Model		Coefficient	95% CI	p-value
Sex (reference: Male)	Female	−748,6	−913,7;-583,5	<0.001
Age		10,5	−0,26;0.21	0.0557
No. of chronic disorders in addition to COPD (reference: 0)	1	905,9	525,5;1286,3	<0.001
	2	1849	1477,8;2220,2	<0.001
	3	2727	2353,6;3100,4	<0.001
	4	4163	3775,3;4550,7	<0.001
	5	5596	5181,9;6010,1	<0.001
	6+	8528	8113,1;8942,9	<0.001
Pharmacy costs, GLM model		Coefficient	95% CI	p-value
Sex (reference: Male)	Female	−23,6	−28,59;-18,61	<0.001
Age		−235,2	−311,5;-158,9	<0.001
No. of chronic disorders in addition to COPD (reference: 0)	1	298,3	124,0;472,6	<0.001
	2	648	477,8;818,2	<0.001
	3	952	780,7;1123,3	<0.001
	4	1278	1099,8;1456,2	<0.001
	5	1633	1442,4;1823,6	<0.001
	6+	1971	1779,7;2162,3	<0.001
No. of emergency department visits, Poisson regression		Exp (Coefficient) - RR	95% CI	p-value
Sex (reference: Male)	Female	0,87	0,84;0.89	<0.001
Age		1.01	1,01;1.02	<0.001
No. of chronic disorders in addition to COPD (reference: 0)	1	1,24	1,15;1.32	<0.001
	2	1,51	1,42;1.59	<0.001
	3	1,78	1,70;1.86	<0.001
	4	2,14	2,06;2.22	<0.001
	5	2,55	2,47;2.64	<0.001
	6+	3,06	2,98;3.15	<0.001
No. of outpatient visits, Poisson regression		Exp (Coefficient) - RR	95% CI	p-value
Sex (reference: Male)	Female	0,86	0,98;0.99	<0.001
Age		0.98	0,85;0.87	<0.001
No. of chronic disorders in addition to COPD (reference: 0)	1	1,47	1,45;1.49	<0.001
	2	1,98	1,96;2.00	<0.001
	3	2,46	2,44;2.48	<0.001
	4	3,01	2,99;3.03	<0.001
	5	3,47	3,45;3.49	<0.001
	6+	4,32	4,30;4.34	<0.001
No. of hospital admissions, Poisson Regression		Exp (Coefficient) - RR	95% CI	p-value
Sex (reference: Male)	Female	0,73	0,70; 0.77	<0.001
Age		1,01	1,01; 1.02	<0.001
No. of chronic disorders in addition to COPD (reference: 0)	1	1,66	1,52; 1.81	<0.001
	2	2,58	2,44; 2.72	<0.001
	3	3,52	3,38; 3.65	<0.001
	4	5,48	5,35; 5.62	<0.001
	5	7,77	7,63; 7.90	<0.001
	6+	12,24	12,10; 12.37	<0.001
Mortality, Logistic regression		Exp (Coefficient) - OR	95% CI	p-value
Sex (reference: Male)	Female	0,64	0,55; 0.74	<0.001
Age		1,13	1,12; 1.13	<0.001
No. of chronic disorders in addition to COPD (reference: 0)	1	1,13	0,75; 1.51	0,52
	2	1,76	1,40; 2.12	0,00196
	3	2,25	1,90; 2.60	<0.001
	4	3,28	2,93; 3.63	<0.001
	5	4,82	4,47; 5.17	<0.001
	6+	7,46	7,11; 7.80	<0.001