Factors associated with high healthcare resource utilisation among COPD patients.
BACKGROUND
Chronic obstructive pulmonary disease (COPD) places a huge economic burden on healthcare systems, especially patients with frequent exacerbations and co-morbidities.


OBJECTIVE
To identify factors associated with high utilisation of healthcare resources in a population of patients with COPD.


METHODS
We conducted an observational, cross-sectional, multicentre study with the aim of identifying the factors associated with high resource utilisation among patients with COPD. Sociodemographic and anthropometric characteristics of the study population, as well as data on health-related quality of life, respiratory symptoms, presence of anxiety and depression, physical activity and lung function were collected. We examined the relationship between these variables and high utilisation of healthcare resources, by performing a multivariate analysis based on a logistic regression model.


RESULTS
115 patients (64 were high users of healthcare resources, and 51 control patients) from 13 hospitals were selected. Patients presenting high resource utilisation had worse FEV₁, worse basal SpO₂, less distance walked in the 6-minute walk test, and increased dyspnoea. They also had a worse BODE index, worse scores in all dimensions of the EURO-QOL 5D and the LCADL scale, and displayed a higher prevalence of depression. Multivariate analysis yielded a statistically significant association between SpO₂, LCADL scores, serum fibrinogen values and total leukocyte count, and high healthcare resource utilisation.


CONCLUSIONS
COPD patients who incur higher healthcare resource utilisation show reduced physical activity, increased respiratory failure and increased systemic inflammation.
Clinical Management Unit of Pneumology and Allergy, Hospital Universitario Puerta del Mar, Avda Ana de Viya 21, 11009 Cádiz, Spain. cayogarcia@neumosur.net
Cayo
C
García-Polo
Bernardino
B
Alcázar-Navarrete
Luis Alberto
LA
Ruiz-Iturriaga
Alberto
A
Herrejón
José Antonio
JA
Ros-Lucas
Patricia
P
García-Sidro
Gema
G
Tirado-Conde
José Luis
JL
López-Campos
Carlos
C
Martínez-Rivera
Joaquin
J
Costán-Galicia
Sagrario
S
Mayoralas-Alises
Javier
J
De Miguel-Díez
Marc
M
Miravitlles
D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D004417:Dyspnea / Q000628:therapy; D015444:Exercise / Q000502:physiology; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006295:Health Resources / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology / Q000628:therapy*; D011788:Quality of Life; D012372:ROC Curve; D012131:Respiratory Insufficiency / Q000209:etiology; D013030:Spain; D014797:Vital Capacity / Q000502:physiology