A Cross-Sectional Comparison of Direct Medical Care Costs among COPD and Asthma Patients Living in the Community in Northern Ireland.
BACKGROUND
Asthma and COPD are known to have significant health and economic consequences. Little is known about the costs of the latter in the UK. In this study we report the results of a comparison of the direct medical costs associated with COPD and asthma, where diagnoses are based on a robust prevalence study of a random sample of the Northern Ireland population.


METHODS
A two-stage survey was used to identify individuals with COPD and asthma. The diagnoses of asthma and COPD were based on patient history and lung function. Patients completed a detailed questionnaire covering healthcare utilization over the past 12 months, socioeconomic characteristics, impact of the disease on quality of life, and activities of daily living.


RESULTS
Forty-nine patients were diagnosed with COPD and 57 with asthma. Three asthma patients were excluded from the main analysis because they were thought to have atypical inpatient stays or other resource use. The mean direct healthcare cost for each COPD patient was estimated at pound171.69 ($US309; year 2000 value) per annum, significantly less than the average cost of asthma among the 54 analyzed of pound544.54 ($US980) [p < 0.05]. A correlation analysis revealed that among COPD patients, disease severity, defined by lung function, was a significant predictor of costs.


CONCLUSIONS
Community-based costs for asthma are greater than those for COPD; this may relate in part to a relative under-diagnosis of COPD (73.5% COPD vs 15.8% asthma). As anticipated, the cost of COPD increases as FEV(1) decreases. Further analysis will enable modeling of the cost consequences of both increased diagnosis and better management of COPD.
Murtagh
Eoin
E
Regional Respiratory Centre, Belfast City Hospital, Belfast, Northern Ireland.
O'neill
Ciaran
C
McAllister
Denise
D
Kee
Frank
F
Macmahon
Joe
J
Heaney
Liam G
LG
D000203:Activities of Daily Living; D001249:Asthma / Q000191:economics; D003430:Cross-Sectional Studies; D017048:Health Care Costs; D006801:Humans; D009660:Northern Ireland; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis; D011788:Quality of Life