title: Determinants and predictors of the cost of COPD in primary care: a Spanish perspective.
abstract: OBJECTIVE
  1) To estimate the annual cost of patients with stable chronic obstructive pulmonary disease (COPD) followed in primary care in Spain; 2) To analyze the possible cost predictor variables.
  
  
  METHODS
  A multicenter, epidemiological, observational, descriptive study. Sociodemographic data, severity of disease, associated comorbidity, treatment followed by patients, quality of life (SF-12 questionnaire), health care resource utilization in the previous 12 months and duration of working disability due to COPD were collected.
  
  
  RESULTS
  A total of 10,711 patients (75.6% men; 24.4% women) with a mean age of 67.1 +/- 9.66 years were evaluated. The mean forced expiratory volume in one second (FEV1) value was 57.4 +/- 13.4%. The total cost per patient per year was Euro1,922.60 +/- 2,306.44. The largest component of this cost was hospitalization (Euro788.72 +/- 1,766.65), followed by cost of drugs (Euro492.87 +/- 412.15) and visits to emergency rooms (Euro134.32 +/- 195.44). Linear regression analysis found associated heart disease, FEV1, physical component of quality of life, number of medical visits (primary care physician, pneumologist and emergency room), hospital admissions (frequency and duration of stay) and duration of working disability to be significant predictors of the total annual cost.
  
  
  CONCLUSIONS
  The total annual cost of a COPD patient followed in primary care in Spain was considered high in this study. The presence of associated heart disease, severity of airflow obstruction, physical component of quality of life, health care resource utilization and duration of work disability were found to be predictor of cost.
authors.affiliation: Department of Pneumology, University Hospital Gregorio Marañón, Madrid, Spain. jmiguel.hgugm@salud.madrid.org
authors.forename: Javier
authors.initials: J
authors.lastname: de Miguel Diez
authors.forename: Pilar
authors.initials: P
authors.lastname: Carrasco Garrido
authors.forename: Marta
authors.initials: M
authors.lastname: García Carballo
authors.forename: Angel
authors.initials: A
authors.lastname: Gil de Miguel
authors.forename: Javier
authors.initials: J
authors.lastname: Rejas Gutierrez
authors.forename: José M
authors.initials: JM
authors.lastname: Bellón Cano
authors.forename: Valentín
authors.initials: V
authors.lastname: Hernández Barrera
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Jimenez García
mesh_terms: D000328:Adult; D000368:Aged; D004185:Disability Evaluation; D016527:Drug Costs; D004636:Emergency Service, Hospital / Q000191:economics; D005260:Female; D005541:Forced Expiratory Volume; D017048:Health Care Costs; D006296:Health Services / Q000191:economics* / Q000706:statistics & numerical data; D006331:Heart Diseases / Q000150:complications / Q000191:economics / Q000628:therapy; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007902:Length of Stay / Q000191:economics; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000191:economics*; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000175:diagnosis / Q000191:economics* / Q000503:physiopathology / Q000628:therapy*; D015272:Pulmonary Medicine / Q000191:economics; D011788:Quality of Life; D012720:Severity of Illness Index; D018582:Sick Leave / Q000191:economics; D013030:Spain; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome