Direct Hospitalization Cost of Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease in Vietnam.

Chau Ngo,Giap Vu,Thuy Thi Bui,Giang Ha,Bach Tran,Long Nguyen,Giang Vu,Cyrus Ho,Hanh Chu,Roger Ho,Ha Ngoc Pham,Phuong Phan,Carl Latkin

doi:10.3390/ijerph16010088

Abstract

Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) have been found to contribute, predominantly, to increasing costs of COPD—a major public health issue. This study aimed to fill the gap in literature concerning costs of AECOPD in Vietnam, by examining the direct cost of AECOPD hospitalization and determining potentially associated factors. A cross-sectional study was conducted at the Respiratory Center of Bach Mai Hospital, Hanoi. A total of 57 participants were selected. Information regarding sociodemographic features, clinical characteristics, and hospitalization costs were collected. A multivariate generalized linear regression model was utilized to determine the factors associated with hospitalization costs. The mean total and daily hospitalization cost were 18.3 million VND (SD = 12.9) and 2.5 million VND (SD = 3.2), respectively. Medication cost accounted for 53.9% of hospitalization cost (from 44.0% in the Global Initiative for Chronic Obstructive Lung Disease Classification A (GOLD A) to 55.3% in GOLD C). Patients having GOLD D COPD (Coef. = 5.78; 95% CI = 0.73–10.83), higher age (Coef. = 0.37; 95% CI = 0.13–0.61), and higher duration of hospitalization (Coef. = 1.91; 95% CI = 1.28–2.53) had higher hospitalization costs (p < 0.05). This study suggested that interventions to screen COPD patients as well as provide timely treatment should be conducted widely in the community in order to avoid any unnecessary hospitalization cost, consequently reducing the economic burden of COPD.

Highlights

Chronic obstructive pulmonary disease (COPD) has been considered a growing threat to global health in the 21st century, as the world population ages, smoking rates increase, and air pollution becomes more severe, especially in Asian regions [1]
This study aimed to examine the direct cost of Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) hospitalization and determine potentially associated factors, to identify areas for possible improvements in cost reduction, resources utilization, and general disease management
This study provides an insight into the hospitalization cost of COPD patients with acute exacerbation in the tertiary care setting in Vietnam

Summary

Introduction

Chronic obstructive pulmonary disease (COPD) has been considered a growing threat to global health in the 21st century, as the world population ages, smoking rates increase, and air pollution becomes more severe, especially in Asian regions [1]. The Global Burden of Disease Study reported an estimated 251 million cases of COPD globally in 2016 [2], which was 3.86 times the number of cases estimated in 2005 [3]. COPD was estimated to result in 3.2 million fatal cases worldwide [4], making it the third leading cause of death and, expectedly, the number one fatality cause by 2030 [5]. Increasing prevalence and severity of impacts of COPD would intensify the economic burden of the disease on the infected and on the society, more so in resource-poor regions [6]. Experts in the field have projected the economic impact of COPD in LMICs to reach £1.7 trillion by 2030 [5]

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