title: Costs and health care resource utilization among chronic obstructive pulmonary disease patients with newly acquired pneumonia.
abstract: BACKGROUND
  Patients with chronic obstructive pulmonary disease (COPD) are at increased risk for lung infections and other pathologies (eg, pneumonia); however, few studies have evaluated the impact of pneumonia on health care resource utilization and costs in this population. The purpose of this study was to estimate health care resource utilization and costs among COPD patients with newly acquired pneumonia compared to those without pneumonia.
  
  
  METHODS
  A retrospective claims analysis using Truven MarketScan(®) Commercial and Medicare databases was conducted. COPD patients with and without newly acquired pneumonia diagnosed between January 1, 2004 and September 30, 2011 were identified. Propensity score matching was used to create a 1:1 matched cohort. Patient demographics, comorbidities (measured by Charlson Comorbidity Index), and medication use were evaluated before and after matching. Health care resource utilization (ie, hospitalizations, emergency room [ER] and outpatient visits), and associated health care costs were assessed during the 12-month follow-up. Logistic regression was conducted to evaluate the risk of hospitalization and ER visits, and gamma regression models and two-part models compared health care costs between groups after matching.
  
  
  RESULTS
  In the baseline cohort (N=467,578), patients with newly acquired pneumonia were older (mean age: 70 versus [vs] 63 years) and had higher Charlson Comorbidity Index scores (3.3 vs 2.6) than patients without pneumonia. After propensity score matching, the pneumonia cohort was nine times more likely to have a hospitalization (odds ratio; 95% confidence intervals [CI] =9.2; 8.9, 9.4) and four times more likely to have an ER visit (odds ratio; 95% CI =4.4; 4.3, 4.5) over the 12-month follow-up period compared to the control cohort. The estimated 12-month mean hospitalization costs ($14,353 [95% CI: $14,037-$14,690]), outpatient costs ($6,891 [95% CI: $6,706-$7,070]), and prescription drug costs ($1,104 [95% CI: $1,054-$1,142]) were higher in the pneumonia cohort than in the control cohort.
  
  
  CONCLUSIONS
  This study demonstrated elevated health care resource use and costs in patients with COPD after acquiring pneumonia compared to those without pneumonia.
authors: Department of Pharmacotherapy, University of Utah, Salt Lake City, UT, USA.
authors: Junji
authors: J
authors: Lin
authors: Health Economics and Outcomes Research, Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA.
authors: Yunfeng
authors: Y
authors: Li
authors: Health Economics and Outcomes Research, Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA.
authors: Haijun
authors: H
authors: Tian
authors: Department of Pharmacotherapy, University of Utah, Salt Lake City, UT, USA.
authors: Michael J
authors: MJ
authors: Goodman
authors: Health Economics and Outcomes Research, Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA.
authors: Susan
authors: S
authors: Gabriel
authors: Health Economics and Outcomes Research, Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA.
authors: Tara
authors: T
authors: Nazareth
authors: Health Economics and Outcomes Research, Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA ; Ernest Mario School of Pharmacy, Rutgers University, New Brunswick, NJ, USA.
authors: Stuart J
authors: SJ
authors: Turner
authors: Health Economics and Outcomes Research, Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA.
authors: Stephen
authors: S
authors: Arcona
authors: Health Economics and Outcomes Research, Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA.
authors: Kristijan H
authors: KH
authors: Kahler
keywords: COPD; cost effectiveness/economics; health care costs; outcomes research