title: Hospitalization Due to Co-Morbid Conditions is the Main Cost Driver Among Subjects With COPD-A Report From the Population-Based OLIN COPD Study.
abstract: BACKGROUND
  Co-morbidities are common in COPD; however, there is a lack of population-based studies evaluating the health economic impact of co-morbid diseases for subjects with COPD. The main objective of this study was to estimate annual direct health-care costs, divided into costs due to non-respiratory and respiratory conditions, comparing subjects with and without COPD.
  
  
  METHODS
  Subjects with and without COPD derived from population-based cohorts in northern Sweden have been invited to annual examinations involving spirometry and structured interviews since 2005. This paper is based on data from 1472 subjects examined in 2006. COPD classification was based on spirometry.
  
  
  RESULTS
  Mean annual costs for both respiratory and non-respiratory conditions were significantly higher for subjects with COPD than non-COPD subjects, in total USD 2139 vs. USD 1276 (p = 0.026), and COPD remained significantly associated with higher costs also after adjustment for common confounders as age, smoking habits, BMI and sex. The mean total cost increased with COPD disease severity and was higher for all severity stages (GOLD) than for non-COPD subjects. Hospitalization due to non-respiratory diseases was the main cost driver in COPD, after adjustment for common confounders amounting to about 46% (unadjusted 62%) of the total COPD-costs.
  
  
  CONCLUSIONS
  Costs were higher for COPD than non-COPD. In COPD, costs for co-morbid conditions were higher than those for respiratory conditions, and hospitalization due to co-morbid conditions was the main cost driver also when adjusted for common confounders.
authors.affiliation: a Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine , The OLIN Unit, Umeå University , SE-901 87 Umeå, Sweden.
authors.forename: Sven-Arne
authors.initials: SA
authors.lastname: Jansson
authors.forename: Helena
authors.initials: H
authors.lastname: Backman
authors.forename: Eva
authors.initials: E
authors.lastname: Rönmark
authors.forename: Bo
authors.initials: B
authors.lastname: Lundbäck
authors.forename: Anne
authors.initials: A
authors.lastname: Lindberg
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000191:economics; D016022:Case-Control Studies; D015897:Comorbidity; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D029424:Pulmonary Disease, Chronic Obstructive / Q000191:economics* / Q000453:epidemiology; D013548:Sweden / Q000453:epidemiology
keywords: COPD; Sweden; cases and controls; cost-of-illness study; health economics