PRS9 LONG-TERM IMPACT of PRIOR Chronic Obstructive Pulmonary Disease Exacerbations on Healthcare Resource Utilisation (HCRU) and Related Costs: An Observational Study (SHERLOCK)

Abstract

Chronic obstructive pulmonary disease (COPD) is associated with high healthcare resource utilisation (HCRU), which increases with COPD severity, exacerbations and comorbidities, and translates into cost burden for the healthcare system. An observational retrospective cohort Study on HEalthcare Resource utiLisation related to exacerbatiOns in patients with COPD (SHERLOCK; D5980R00014) evaluated the clinical and HCRU impact and related costs of exacerbations in primary care patients. Patients in NHS Glasgow ≥40 years of age with COPD were stratified by exacerbation history in the prior year: Group A (none), B (1 moderate), C (1 severe) and D (≥2 moderate and/or severe). HCRU and related costs (all-cause and COPD only; inpatient stays: days in general wards and intensive care; general practitioner and emergency room visits; drugs) were assessed over 3 years (1st January 2014 – 31st December 2016). Cost per patient was calculated by assigning unit costs to resource use for each patient. Mean cost per patient was calculated for each group. Unit costs were obtained from the British National Formulary and standard NHS reference costs. Overall, 22462 patients were included. The all-cause and COPD costs, respectively, at Year 1 were: £1690 and £766 (Group A), £1753 and £817 (Group B), £3629 and £1501 (Group C) and £2768 and £1428 (Group D). Differences were seen in general ward costs across cohorts, while other costs were comparable across groups. Differences in cumulative costs persisted at Year 2 and Year 3 and were proportionally comparable, across groups, to the results at Year 1. Increased costs were seen in patients with higher frequency or severity of exacerbations in the prior year. Results were driven by general ward costs. Clinical management of COPD should be aimed at minimising the risk of exacerbations thus saving healthcare system costs, as well as hospital capacity for more urgent patients.