The Cost and Outcome of Treatment of Patients Admitted with Acute Exacerbation of Chronic Obstructive Pulmonary Disease in Shiraz, Southern Iran

Abstract

Abstract Background Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) decreases lung function and quality of life, and is the main driver of the costs of chronic obstructive pulmonary disease (COPD), the treatment of which in hospital is highly expensive. The present study aimed at determining the costs and outcomes of treatment of the patients hospitalized with AECOPD in Shahid Faqihi Hospital in Shiraz in 2021. Methods The present cost-outcome analysis was conducted as a descriptive-analytical, retrospective study. The research tool was a researcher-made form prepared and used to extract the patients' demographic and clinical information as well as the outcome and direct and avoidable medical costs, after consultations with some experts. In order to analyze the collected data, descriptive and inferential statistics indicators (t-tests with two independent groups and analysis of variance) were used and the data were analyzed using Excel and SPSS23 statistical software. Results Most of the studied patients were male (70.7%), and 81.3% of the patients had comorbidities. Besides, 76% of the patients had experienced disease exacerbation at most twice a year and 69.3% had been hospitalized < 7 times in the last year. The total average direct and avoidable medical costs were $2620 and $754, respectively. The financial burdens of avoidable antibiotics, stay, ICU, and lung CT scan in 2021 were $1,501, $3,244, $869, and $1,856, respectively. Of all the patients, 80.6% were discharged with full recovery, 7.3% were transferred to ICU, and 10.7% died. The number of hospitalization days, the use of other drugs, and AECOPD with brain disease had a significant effect on the patients’ total medical costs (p < 0.01). Conclusion Prevention of AECOPD, especially moderate or severe ones, is potentially cost-effective. Given that exacerbations can impose a large financial burden on patients and insurers, they will certainly lead to resource loss and prevent the resources from being allocated to effective interventions. Therefore, the use of effective clinical guidelines seems necessary to prescribe avoidable services to patients with AECOPD.