title: Impact of chronic ischemic heart disease on the health care costs of COPD patients - An analysis of German claims data.
abstract: Chronic Obstructive Pulmonary Disease (COPD) has a substantial impact on health care systems worldwide. Particularly, cardiovascular diseases such as ischemic heart disease (IHD) are frequent in individuals with COPD, but the economic consequences of combined COPD and IHD are by large unknown. Therefore, our study has the objective to investigate excess costs of IHD in COPD patients.
  
  
  
  Out of German Statutory Health Insurance claims data we identified 26,318 COPD patients with and 10,287 COPD patients without IHD based on ICD-10 codes (COPD J44; IHD I2[0,1,2,5]) of the year 2011 and matched 9986 of them in a 1:1 ratio based on age and gender. Then, we investigated health care service expenditures in 2012 via Generalized Linear Models. Moreover, we evaluated a potential non-linear association between health care expenditures and age in a gender-stratified Generalized Additive Model.
  
  
  
  The prevalence of IHD in individuals with COPD increases with rising age up to a share of 50%. COPD patients with IHD cause adjusted mean annual per capita health care service expenditures of ca. €7400 compared with ca. €5800 in COPD patients without IHD. Moreover, excess costs of IHD have an inverse u-shape, peaking in the early (men) respectively late seventies (women).
  
  
  
  IHD in COPD patients is associated with excess costs of ca. € 1,500, with the exact amount varying age- and gender-dependently. Subgroups with high excess costs indicate medical need that calls for efficient care strategies, considering COPD and IHD together particularly between 70 and 80 years of age.
authors: Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Institute of Health Economics and Health Care Management, Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Ingolstaedter Landstrasse 1, 85764 Neuherberg, Germany. Electronic address: l.schwarzkopf@helmholtz-muenchen.de.
authors: Larissa
authors: L
authors: Schwarzkopf
authors: Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Institute of Health Economics and Health Care Management, Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Ingolstaedter Landstrasse 1, 85764 Neuherberg, Germany.
authors: Margarethe
authors: M
authors: Wacker
authors: Arvato Health Analytics GmbH, Landsberger Straße 154, 80339 München, Germany.
authors: Julia
authors: J
authors: Ertl
authors: Arvato Health Analytics GmbH, Landsberger Straße 154, 80339 München, Germany.
authors: Jana
authors: J
authors: Hapfelmeier
authors: Arvato Health Analytics GmbH, Landsberger Straße 154, 80339 München, Germany; IGES Institut GmbH, Friedrichstraße 180, 10117 Berlin, Germany.
authors: Katharina
authors: K
authors: Larisch
authors: Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Institute of Health Economics and Health Care Management, Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Ingolstaedter Landstrasse 1, 85764 Neuherberg, Germany; Ludwig-Maximilians-Universität, Munich Center of Health Sciences, Ludwigstr. 28 RG, 80539, München, Germany.
authors: Reiner
authors: R
authors: Leidl
mesh_terms: D000067575:Administrative Claims, Healthcare / Q000191:economics*; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D017281:Cost of Illness; D005260:Female; D005858:Germany / Q000453:epidemiology; D017048:Health Care Costs / Q000706:statistics & numerical data* / Q000639:trends; D006296:Health Services / Q000191:economics* / Q000706:statistics & numerical data; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications* / Q000191:economics* / Q000453:epidemiology; D017063:Outcome Assessment, Health Care; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000191:economics* / Q000453:epidemiology
keywords: Administrative data; Comorbidity; Cost of illness; Excess costs; Matched pair; Payer perspective