Impact of moderate and severe exacerbations on clinical prognosis and economic burden of chronic obstructive pulmonary disease in China.

IF 1.8 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Expert Review of Pharmacoeconomics & Outcomes Research Pub Date : 2025-05-19 DOI:10.1080/14737167.2025.2507425

Lei Gan, Xiaoning He, Jing Wu

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引用次数: 0

Abstract

Objectives: Different severities of exacerbations of chronic obstructive pulmonary disease (AECOPD) will lead to different disease progression and economic burden. This study aimed to evaluate the impact of the severity of AECOPD on disease burden.

Methods: Data were from the Tianjin Urban Employee Basic Medical Insurance Database (2016-2020). COPD patients were stratified by severity of AECOPD: (A) no AECOPD, (B) moderate AECOPD only; and (C) ≥1 severe AECOPD. Key outcomes included rate of AECOPD, mortality, COPD-related cost. Sensitivity analysis of reducing the impact of COVID-19 in outcomes was conducted.

Results: 6738 patients were identified, with 22.5% for Group A, 41.1% for Group B and 36.4% for Group C. During 1st follow-up year, Group C experienced an average of 1.43 severe AECOPD, leading to a notably increased all-cause mortality (Group C vs A-B: 17.7% vs. 2.6-3.4%, p < 0.001), highest COPD-related costs (CNY 30,245 vs 1,700-6,923). In the second year, patients in Group C still had a highest rate of severe AECOPD (0.44 vs 0.08-0.11 vs, p < 0.001), as well as increased all-cause mortality.

Conclusion: Severe AECOPD significantly increased mortality rates and economic burden in the current and subsequent year. This underscored the imperative need to enhance severe AECOPD management.

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中国慢性阻塞性肺疾病中重度加重对临床预后和经济负担的影响

目的：不同程度的慢性阻塞性肺疾病（AECOPD）加重会导致不同的疾病进展和经济负担。本研究旨在评估AECOPD严重程度对疾病负担的影响。方法：数据来源于天津市城镇职工基本医疗保险数据库（2016-2020年）。COPD患者按AECOPD严重程度分层：(A)无AECOPD， (B)仅为中度AECOPD；(C)≥1例重度AECOPD。主要结局包括AECOPD率、死亡率、copd相关费用。对降低COVID-19对结局的影响进行敏感性分析。结果：6738例患者中，A组22.5%，B组41.1%，C组36.4%。随访1年，C组平均发生1.43例严重AECOPD，导致全因死亡率显著升高（C组与A-B组：17.7% vs. 2.6-3.4%, p p）。结论：严重AECOPD显著增加了当年和次年的死亡率和经济负担。这凸显了加强AECOPD严格管理的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Pharmacoeconomics & Outcomes Research HEALTH CARE SCIENCES & SERVICES-PHARMACOLOGY & PHARMACY

CiteScore

4.00

自引率

4.30%

发文量

审稿时长

6-12 weeks

期刊介绍： Expert Review of Pharmacoeconomics & Outcomes Research (ISSN 1473-7167) provides expert reviews on cost-benefit and pharmacoeconomic issues relating to the clinical use of drugs and therapeutic approaches. Coverage includes pharmacoeconomics and quality-of-life research, therapeutic outcomes, evidence-based medicine and cost-benefit research. All articles are subject to rigorous peer-review. The journal adopts the unique Expert Review article format, offering a complete overview of current thinking in a key technology area, research or clinical practice, augmented by the following sections: Expert Opinion – a personal view of the data presented in the article, a discussion on the developments that are likely to be important in the future, and the avenues of research likely to become exciting as further studies yield more detailed results Article Highlights – an executive summary of the author’s most critical points.