title: Ten-Year Trends in Direct Costs of COPD: A Population-Based Study.
abstract: BACKGROUND
  Up-to-date estimates of burden of diseases are required for evidence-based decision-making. The objectives of this study were to determine the excess costs of COPD and its trend from 2001 to 2010 in British Columbia, Canada.
  
  
  METHODS
  We used British Columbia's administrative health data to construct a cohort of patients with COPD and a matched comparison cohort of subjects without COPD. We followed each patient from the time of first COPD-related health-care event (or equivalent time for the comparison cohort). Direct medical costs (in 2010 Canadian dollars [$]) were calculated based on billing records pertaining to hospital admissions, outpatient services use, medication dispensations, and community care services. We determined the excess medical costs of COPD by calculating the difference in overall medical costs between the COPD and the comparison cohorts.
  
  
  RESULTS
  The COPD and comparison cohorts comprised 153,570 and 246,801 people, respectively (for both cohorts, mean age at entry was 66.9 years; 47.2% female patients). The excess costs of COPD during the study period were $5,452 per patient-year. Inpatient, outpatient, medication, and community care costs were responsible for 57%, 16%, 22%, and 5% of the excess costs, respectively. Excess costs increased by $296/person-y (P < .01), with hospital costs demonstrating the largest increase over time ($258/person-y; P < .01).
  
  
  CONCLUSIONS
  The direct economic burden of COPD is high and has increased significantly between 2001 and 2010 over and above the increase in the health-care costs of the general population. Further investigation is required to elucidate the underlying reasons for the temporal increase in COPD direct costs.
authors.affiliation: Collaboration for Outcomes Research and Evaluation, the University of British Columbia, Vancouver, BC.
authors.forename: Amir
authors.initials: A
authors.lastname: Khakban
authors.affiliation: Faculty of Pharmaceutical Sciences, Institute for Heart 1 Lung Health, the University of British Columbia, Vancouver, BC.
authors.forename: Don D
authors.initials: DD
authors.lastname: Sin
authors.affiliation: Faculty of Pharmaceutical Sciences, Institute for Heart 1 Lung Health, the University of British Columbia, Vancouver, BC.
authors.forename: J Mark
authors.initials: JM
authors.lastname: FitzGerald
authors.affiliation: Institute for Heart 1 Lung Health, Center of Excellence for Prevention of Organ Failure (PROOF Centre), Vancouver, BC.
authors.forename: Raymond
authors.initials: R
authors.lastname: Ng
authors.affiliation: Collaboration for Outcomes Research and Evaluation, the University of British Columbia, Vancouver, BC.
authors.forename: Zafar
authors.initials: Z
authors.lastname: Zafarí
authors.affiliation: Institute for Heart 1 Lung Health, Center of Excellence for Prevention of Organ Failure (PROOF Centre), Vancouver, BC.
authors.forename: Bruce
authors.initials: B
authors.lastname: McManus
authors.affiliation: Institute for Heart 1 Lung Health, Center of Excellence for Prevention of Organ Failure (PROOF Centre), Vancouver, BC.
authors.forename: Zsuzsanna
authors.initials: Z
authors.lastname: Hollander
authors.affiliation: School of Pharmacy, Memorial University of Newfoundland, St. John's, NF, Canada.
authors.forename: Carlo A
authors.initials: CA
authors.lastname: Marra
authors.affiliation: Faculty of Pharmaceutical Sciences, Institute for Heart 1 Lung Health, the University of British Columbia, Vancouver, BC; Department of Medicine, Respiratory Division, and the Centre for Clinical Epidemiology and Evaluation, the University of British Columbia, Vancouver, BC. Electronic address: msafavi@mail.ubc.ca.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Sadatsafavi
mesh_terms: D000368:Aged; D001955:British Columbia / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D017048:Health Care Costs / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000191:economics* / Q000453:epidemiology; D013997:Time Factors