For the 5th International Workshop on Lung Health, a call for Posters was launched in May 2017.
The 56 abstracts received were evaluated by the Committee for their consistency with the congress topics and the scientific value.
The accepted posters had a dedicated strolling session during the congress where the presenters had the chance to illustrate their work to the chairmen. At the end of the session the chairmen chose, among the posters presented, the best three works—the abstracts of which are given hereafter.
The winners have received free registration for the next congress and good visibility both through the website and the congress newsletter.
In May 2018, the call for Abstracts will be open for the 5th International Workshop on Lung Health to be held in Berlin in January 2018.
Poster Awards' Winners Abstracts
Measuring the impact of COPD on daily communication: A clinimetric study
Jessie Lemmens1; Nicola Merkel1; Janina Muenstermann1; Tanja Vossen2
1Zuyd University of Applied Sciences, Heerlen, Netherlands; 2Proteion, Horn, The Netherlands
COPD is a highly prevalent disease that has a large impact on quality of life. To examine the symptoms that are related to communication, a questionnaire has been developed by a Dutch speech and language therapist (Vossen, 2008). It consists of four self-report scales concerning breathing, speech, voice, & swallowing and a performance assessment in which a short text is read. Each item is rated on a 12-point (Borg) scale. The Dutch version proved to be a reliable and valid tool (Lenders et al, 2015; Marien et al, 2016) and thus was translated into German (Hille & Lemberg, 2015). In this study, the internal consistency, test–retest reliability (self-report items), intraobserver reliability (performance assessment), and the discriminant validity according to GOLD stages of the German version were examined. Fifty-three Germans suffering from COPD were recruited via sport lung groups, self-help groups, hospitals, and general practitioners offices. Fifty people, of which 26(52%) were females, completed the questionnaire twice in a two-week time period and 30 allowed the performance of reading a text to be recorded for analysis. The mean age was 66 (sd = 9.3), ranging between 41 and 83, and 33(66%) were retired. The majority 42(84%) did not smoke (anymore). Most prevalent (n = 18/36%) was GOLD stage II and the other stages varied between 9 and 5 people. From 10 people, the GOLD stage was not reported. According to the self-report items, the main difficulties concerning communication were breathing while experiencing strain (100%) and voice production (64%). The least problems were reported in swallowing (26%). The internal consistency in both measurements was high (Cronbach alfa >0.8) for the total scale, the breathing scale, and the reading scale, sufficient (Cronbach alfa = 0.7) for the voice scale and poor (Cronbach's alfa = resp.0.6/.44) for the swallow scale. The correlation calculated via resp. weighed kappa and ICC between the first and second measurements of the self-report items ranged between >0.8 and 0.93 for all subscales and total scores. The intraobserver analysis showed a weighed kappa of 0.96. There were significant differences (p < 0.05) in scores between GOLD I and GOLD II & IV. The sample size of GOLD III was only five people, which was most likely too small for ANOVA testing. While several other health questionnaires focus on consequences of COPD, so far no reliable instrument concentrated on communication difficulties caused by COPD. This questionnaire is reliable and can be used to record communication problems in a German population with COPD. Even though further validity testing is recommend, the results of this study may help raise awareness that the impact on communication is larger than expected. The role of speech therapy in COPD treatment within the German Health Care system should be further investigated.
BODE index and CAT-test in the evaluation of pulmonary rehabilitation in chronic obstructive pulmonary disease patients with obesity
Olga Nesterovska1; Ganna Stupnytska2
1Bukovinian State Medical University, Chernivtsi, Ukraine; 2Bukovinian State Medical University, Chernivtsi, Ukraine
Pulmonary rehabilitation (PR) is considered to be one of the main methods of treatment and many studies have demonstrated its effectiveness in reducing dyspnea, increasing exercise capacity and improving quality of life. In order to evaluate the effectiveness of PR, integral indices, in particular the BODE index, are suggested to be used.
Objective
To determine the effectiveness of PR in COPD patients with obesity using the BODE index and the CAT-test.
Material and methods
Pulmonary rehabilitation involved 48 patients with COPD and obesity. The BODE index (body mass index, forced expiratory volume in one second, dyspnea, and 6-min walk distance) and the CAT-test were evaluated before and after a 6-month PR program. In addition to the PR, patients with COPD and obesity were prescribed a diet and physical aerobic exercise to reduce body weight.
Results
The initial level of the BODE index and the CAT test in COPD patients with obesity was 4.96 ± 0.56 and 18.72 ± 1.71, respectively. After 6 months of PR, the BODE decreased reliably by 22.4%. The CAT test in COPD patients with obesity also decreased reliably by 32.4%. In the structure of the BODE index, dyspnea and exercise capacity had the best dynamics (the number of points on the mMRC scale decreased by 23.3% and an increase in the distance traveled by patients in a 6-minute walk test from 232.04 ± 19.19 to 261, 84 ± 21.37). The body mass index decreased by 10.4%. FEV1 after the PR decreased slightly (by 9.4%).
Conclusions
This study shows that COPD patients with obesity need a complex of physical exercises and a diet that contributes to lowering the body mass index and dyspnea; improving exercise capacity and COPD symptoms to be added to the PR.
Healthcare Spending and Utilization of Lung Cancer Patients Using 2002–2012 Nationwide Health Insurance Claims Data
Sun Jung Kim, MHSA, PhD1; Park Eun-Cheol, MD, PhD2; Nam Chung Mo, PhD2; Lee Sang Gyu, MD, PhD, MBA3; Park Sohee, PhD3; Kim Tae Hyun, PhD3
1Soonchunghyang University Department of Health Administration & Management, Asan, Korea,South; 2Yonsei University College of Medicine, Department of Preventive Medicine, Seoul, Korea, South; 3Yonsei University Graduate School of Public Health, Seoul, Korea, South
Background
Over the past decades, lung cancer has one of the highest fatality rates, and is the leading cause of cancer-related mortality and disease burden not only in South Korea but also worldwide. Studies focused on lung cancer are well-documented, however, the factors that are associated with healthcare spending and utilization using long periods of large dataset are less researched in this country. The purpose of this study was to investigate how different individual and hospital factors are associated with total, inpatient, outpatient spending and utilizations measured by length of stays and outpatient days among nationwide dead or 5 year follow-up lung cancer patients using 2002–2012 health insurance claims data.
Materials and methods
We used nationwide lung cancer patients' health insurance claims during 2002–2012 which accounted for 1,417,380 (673,122 inpatients and 744,258 outpatients). We transposed the dataset into a retrospective cohort design study that the unit of analysis is information of each lung cancer patient. We included patients who were newly diagnosed with lung cancer after 2005 and dead or follow-up of 60 months which eventually included patients diagnosed during 2005–2007. Furthermore, this study also excluded patients who had inpatient spending less than KRW 400,000 to minimize bias of real lung cancer patient selection. We then calculated various spending and utilization measures (total, inpatient, outpatient spending, length of stays, and outpatient days). Finally, we obtained total population for analysis of 53,451 lung cancer patients and matched 916 hospitals. Hospital data included characteristics of the hospital, such as hospital type, teaching status, number of beds, specialists, and nurses. In order to investigate individual and hospital factors associated with healthcare spending and utilization of lung cancer patients, multilevel linear mixed models that avoid problems created by possible nesting of patient-level observations within hospital clusters and overestimation of significance were performed.
Results
Our retrospective cohort design study using nationwide claim data of past decade showed that increase in new lung cancer cases during year 2005–2007 (16,654 in 2005, 18,149 in 2006, 18,648 in 2007 which are similar to actual number of patients reported by national cancer center), increased spending and utilization (total spending of KRW 22,883,645 to KRW 27,462,222; inpatient LOS of 51.4 days to 58.8 days; outpatient utilization of 25.4 days to 26.1 days for patient diagnosed in 2005 and 2007 respectively), and higher proportion of spending and utilization during very first periods after diagnosis and last periods before death or follow-up ends of lung cancer patients (about 70% over total), and higher spending and utilization trend among dead population (5-year survivors: total spending of KRW 24,486,381, inpatient LOS of 39.2 days, outpatient utilization of 40.9 days; Dead population: total spending of KRW 15,936,865∼54,945,330, inpatient LOS of 44.4∼107.8 days, Outpatient utilization of 9.0∼66.0 days). Using the multilevel linear mixed analysis models, we found evidences of differences in the use of healthcare resources among individual and hospital factors that individual with health insurance (2.9% higher in total spending, P < 0.001; 23.8% higher in outpatient days, P < 0.001), male (5.6% higher in total spending, P < 0.001; 8.6% higher in outpatient days, P < 0.001), 40–79 age group (28.0% to 61.0% higher in total spending, P < 0.001; 24.8% to 34.0% in LOS, P < 0.001; 38.9% to 65.8% higher in outpatient days, P < 0.001) and hospital type with tertiary/large (27.6%, 12.7% higher in total spending), teaching (35.6% higher in total spending, P < 0.001; 13.4% higher in LOS, P = 0.001; 21.9% higher in outpatient days, P < 0.001) had relatively higher spending and utilization among nationwide 5 year follow-up lung cancer patients.
Discussion & conclusion
This study might suggest that the efficient manner of healthcare policy implementation for patients' spending and utilization in order to maintain financial viability of national health insurance program that the allocation of limited health-care resources demands an agreed rational allocation principle, and consequently priority setting is considerably important. In addition, healthcare spending and utilization considered to be targeted to underserved population groups that will ensure efficient locus of healthcare service delivery to different subpopulation groups. Results of this study might be useful to health policy makers not only in South Korea but also to international readers who need to develop a national cancer management strategy that reduces differences in the use of healthcare resources and flexible healthcare benefits plan which might helpful to targeted subpopulation groups.