title: Clinical factors and comorbidities affecting the cost of hospital-treated COPD.
abstract: OBJECTIVE
  We aimed to assess the effects of comorbidities on COPD costs and to investigate the relationship between comorbidities and clinical variables.
  
  
  METHODS
  All patients hospitalized with a diagnosis of COPD exacerbation between January 1, 2014, and December 31, 2014, at all state hospitals of Aydın province, a city located in the western part of Turkey, were included in this study. The costs examined in the study pertained to medications, laboratory tests, hospital stays, and other treatment-related factors, such as consumption of materials, doctor visits, and consultation fees.
  
  
  RESULTS
  A total of 3,095 patients with 5,237 exacerbations (mean age, 71.9±10.5 years; 2,434 males and 661 females) were evaluated. For 880 of the patients (28.9%), or 3,852 of the exacerbations (73.1%), at least one comorbid disease was recorded. The mean cost of each exacerbation was $808.5±1,586, including $325.1±879.9 (40.7%) for hospital stays, $223.1±1,300.9 (27.6%) for medications, $46.3±49.6 (0.9%) for laboratory expenditures, and $214±1,068 (26.5%) for other treatment-related factors, such as consumption of materials, doctor visits, and consultation fees. The cost of each exacerbation was $1,014.9 in patients with at least one comorbidity, whereas it was $233.6 in patients without comorbidity (P<0.001). Age >65 years, female gender, hospitalization in an intensive care unit, invasive or noninvasive mechanical ventilation, and a long duration of hospitalization were all found to be significant factors in increasing total costs during the exacerbations requiring hospitalization (P<0.05 for all).
  
  
  CONCLUSIONS
  Comorbidities have an important role in the total costs of acute exacerbations of COPD. Strategies for the prevention, diagnosis, and effective management of comorbidities would decrease the overall financial burden associated with acute exacerbations of COPD.
authors.affiliation: Clinics of Chest Diseases, Dr Suat Seren Chest Diseases and Thoracic Surgery Education and Research Hospital, İzmir.
authors.forename: Sami
authors.initials: S
authors.lastname: Deniz
authors.affiliation: Clinics of Chest Diseases, Kocaeli Derince Research and Education Hospital, Kocaeli.
authors.forename: Aysun
authors.initials: A
authors.lastname: Şengül
authors.affiliation: Department of Chest Diseases, Sakarya University Faculty of Medicine, Sakarya.
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Aydemir
authors.affiliation: Clinics of Chest Diseases, Turgutlu State Hospital, Manisa.
authors.forename: Jülide
authors.initials: J
authors.lastname: Çeldir Emre
authors.affiliation: Department of Chest Diseases, Faculty of Medicine, Ege University İzmir, Turkey.
authors.forename: Mustafa Hikmet
authors.initials: MH
authors.lastname: Özhan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D016527:Drug Costs; D005260:Female; D005102:Health Expenditures; D017721:Hospital Costs; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008297:Male; D008875:Middle Aged; D018803:Models, Economic; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000191:economics* / Q000453:epidemiology / Q000628:therapy*; D012017:Referral and Consultation / Q000191:economics; D012129:Respiratory Function Tests / Q000191:economics; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology
keywords: COPD; comorbidity; cost; exacerbation; intensive care unit; morbidity