PRS22 Exacerbation-Related Costs and Health Resource Use in COPD Patients in the Brazilian Private Healthcare System

Abstract

Describe patient characteristics, exacerbation-related health resource use (HRU) and associated costs for COPD patients in the Brazilian private healthcare system (PHS) between 2015 and 2019. Retrospective cohort study assessing Brazilian health claims data from Orizon. Patients aged ≥40 years, who had a COPD claim with ICD-10 J40 to J44 and 2 years of available data after the first COPD claim were included, also classified during the first year. HRU and costs were assessed in the second year of the patients’ follow-up. COPD exacerbation was defined as an emergency visit (EV) or hospital admission (HA) related to the following ICD-10: J00-J06, J09-J11, J12-J18, J20-J22, J40-J47, J80, J96. Mean and standard deviation (SD) for the HRU costs were calculated and adjusted according to the Broad National Consumer Price Index (IPCA) to reflect 2019 prices in Brazilian currency (R$). 1,254 COPD patients were assessed, predominatly women (55.11%), median age 65 years and had a severe COPD exacerbation in the first year (65,8%). Ambulatory visits were the most prevalent first COPD event (64.27%), followed by EV (19.62%) and HA (10.61%). In the second year of follow-up, 7.5% of patients had at least one exacerbation; among these, 7% had at least one EV and 3.6% had at least one HA related to COPD. 37.8% of all HA were followed by an intensive care unit (ICU) stay. EV and HA related to COPD cost R$ 755,45 (SD = R$ 818,94) and R$ 30.591,00 (SD = R$ 34.711,42), respectively. HA with ICU stay cost 70% more (R$ 53.190,00, SD = R$ 47.532,36) than general hospitalization. COPD exacerbation places a high economic burden on the Brazilian PHS, especially regarding hospitalization and ICU stay. Strategies should be implemented to minimize the number and severity of such events in the longer term.