PRS30 - HOSPITAL MANAGEMENT OF ACUTE COPD EXACERBATION AND IMPACT ON HOSPITAL RE-ADMISSION IN FRANCE

Abstract

Acute exacerbations are common complications of COPD with a significant impact on patient’s quality of life. The main objectives of the study are to describe the hospital management and estimate the burden of acute COPD exacerbations. This population-based retrospective cohort study was performed by using the French exhaustive National hospital discharge database (PMSI). Patients ≥ 40 years old, who had a hospitalisation for an acute COPD exacerbation between January, 1st 2015 and December, 31st 2016, were included. The hospitalisations for an acute COPD exacerbation were defined using the two validated Institut National Veille Sanitaire (INVS) algorithms (narrow and broad definition) which combine several diagnosis codes according to the ICD-10 (International Classification of Diseases). Each patient included before June 30th, 2016, was followed-up for 6 months after cohort entry date and additional hospitalisations for acute COPD exacerbation were retrieved, according to the same algorithms. Results of the narrow INVS algorithm only are presented. Hospital costs associated with acute COPD exacerbations were estimated using published official tariffs in France for the period expressed in 2018 Euro. 74,460 patients were hospitalized in 2015 and 74,518 in 2016 for an acute COPD exacerbation. The global evolution was + 0.08% from 2015 to 2016. The mean age of patients was 74 ± 12.2 years old; 62.2% of them were males. Among the 108,928 patients included before June 30th, 2016, 18,018 (16.5%) were rehospitalized for the same reason within 6 months. The average hospital cost of this 6-month 1st rehospitalisation for an acute COPD exacerbation was € 4,800.94 ± 4,490.06. This study confirms the high epidemiological and economic burden of the hospitalisations for acute COPD exacerbation in France. A focus for new interventions and education should be made to decrease this level of spending in future.