Healthcare costs of COPD in Italian referral centres: a prospective study.
BACKGROUND
This study estimated the healthcare resource utilisation and costs of chronic obstructive pulmonary disease (COPD) patients, staged by severity, in the Italian pneumology departments (PDs).


METHODS
The project was a multi-centre observational study conducted in 11 Italian PDs throughout the country. A total of 268 patients were recruited and followed prospectively for 1 year. For the purpose of analysis, patients were divided into four groups according to the severity at onset: mild COPD (stage I)-postbronchodilator FEV1/FVC <70% and FEV1 >or=80% of predicted; moderate COPD (stage II)-postbronchodilator FEV1/FVC <70% and 50% <or=FEV1< 80% of predicted; severe COPD (stage III)-postbronchodilator FEV1/FVC <70% and 30% <or=FEV1 <50% of predicted; very severe COPD (stage IV)-postbronchodilator FEV1/FVC <70% and FEV1 <30% of predicted, or clinical signs of either respiratory or cardiac failure.


RESULTS
Subgroups differed significantly in the main demographic and clinical variables. Broadly, higher severity was associated with older age, longer disease duration, and more frequent exacerbations. Patients with severe COPD used more resources for almost all services than those with mild and moderate forms. The annual average cost per patient was 3040.2 euros (1046.7 euros for mild, 2319.0 euros for moderate, 3572.1 euros for severe and 5033.3 euros for very severe forms).


CONCLUSIONS
This study offers some information on the healthcare costs of COPD induced by PDs in Italy, potentially useful for decision-making in the health care services. Resources and costs rose significantly with disease severity.
CESAV, Centre for Health Economics, Mario Negri Institute for Pharmacological Research, Villa Camozzi-Via Camozzi, 3 24020 Ranica (Bg), Italy.
Daniela
D
Koleva
Nicola
N
Motterlini
Paolo
P
Banfi
Livio
L
Garattini
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006295:Health Resources / Q000706:statistics & numerical data*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy / Q000191:economics* / Q000453:epidemiology; D012017:Referral and Consultation / Q000191:economics; D013222:State Medicine