Abstract
ObjectiveTo investigate the characteristics and medical expenditures of patients with Asthma- chronic obstructive pulmonary disease (COPD) overlap (ACO) compared to asthma and COPD patients.MethodsThis was a retrospective cohort study involving patients diagnosed with ACO, asthma or COPD as of January 2016. Medical records for patients attending King Abdullah University Hospital (KAUH), in northern Jordan, during the years 2015–2016 were used to identify eligible patients and all relevant clinical characteristics. Both respiratory and all-cause charges were extracted from KAUH billing system during the year 2016. Total, inpatient, outpatient, and pharmacy charges were described and compared across the three disease categories. Charges were measured in Jordanian Dinar (JOD, equal to 1.41 US Dollar).ResultsOf a total of 761, 87 ACO patients, 494 asthmatic patients and 180 COPD patients were identified and included in this study. The average total respiratory-related charges were significantly higher in patients with ACO compared to patients with asthma (601.4 versus 354.3 JODs; P value < 0.001). Average all-cause charges were higher in case of ACO and COPD compared to patients with asthma (1830.8 and 1705.4 versus 1251.7 JODs; P value < 0.001). ACO was a significant predictor of higher respiratory and all-cause related charges. Respiratory charges were also higher in older patients and those with higher disease severity.ConclusionsACO is a risk factor for incurring higher health expenditures in Jordan. Higher respiratory expenditures are also associated with older ages and higher disease severity.
Highlights
Asthma and chronic obstructive pulmonary disease (COPD) are common respiratory diseases that have distinctive clinical and pathophysiological features [1]
Average all-cause charges were higher in case of Asthma-COPD overlap (ACO) and COPD compared to patients with asthma (1830.8 and 1705.4 versus 1251.7 Jordanian Dinars (JOD); P value < 0.001)
494 asthmatic patients, 180 COPD patients and 87 ACO patients were identified during the study time and were included in the study
Summary
Asthma and chronic obstructive pulmonary disease (COPD) are common respiratory diseases that have distinctive clinical and pathophysiological features [1]. The global prevalence of ACO has been estimated to be around 2.0% of the general population and varied across population-based studies from 3.2 to 51.4% among patients with asthma, and from 13.0 to 55.7% among patients with COPD [5]. These variations in prevalence across the countries are due to variations in COPD and asthma diagnostic criteria, in addition to the population demographics including age, gender, and smoking status [6]. Patients with ACO have been shown to have greater health care costs compared with asthma or COPD patients alone [11,12,13]. To date, diagnosing and managing ACO is still challenging and need further efforts and evidence-based management guidelines [16, 17]
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