Kim, Changhwan
(Department of Internal Medicine, Jeju National University Hospital, Jeju National University School of Medicine)
,
Kim, Younhee
(Institute of Health and Environment, School of Public Health, Seoul National University)
,
Yang, Dong-Wook
(Graduate School of Public Health, Seoul National University)
,
Rhee, Chin Kook
(Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea)
,
Kim, Sung Kyoung
(Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea)
,
Hwang, Yong-Il
(Department of Internal Medicine, Hallym University Sacred Heart Hospital)
,
Park, Yong Bum
(Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital)
,
Lee, Young Mok
(GF Allergy Clinic)
,
Jin, Seonglim
(Beautiful Breath Clinic)
,
Park, Jinkyeong
(Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital)
,
Hahm, Cho-Rom
(Department of Internal Medicine, Gwangmyeong Sungae Hospital)
,
Park, Chang-Han
(Department of Internal Medicine, Sungae Hospital)
,
Park, So Yeon
(A&A Clinic)
,
Jung, Cheol Kweon
(Sanbon Yonsei Clinic)
,
Kim, Yu-Il
(Department of Internal Medicine, Chonnam National Univer)
,
Lee, Sang Haak
,
Yoon, Hyoung Kyu
,
Lee, Jin Hwa
,
Lim, Seong Yong
,
Yoo, Kwang Ha
Background: Understanding the burden of disease is important to establish cost-effective treatment strategies and to allocate healthcare resources appropriately. However, little reliable information is available regarding the overall economic burden imposed by chronic obstructive pulmonary disease (...
Background: Understanding the burden of disease is important to establish cost-effective treatment strategies and to allocate healthcare resources appropriately. However, little reliable information is available regarding the overall economic burden imposed by chronic obstructive pulmonary disease (COPD) in Korea. Methods: This study is a multicenter observational research on the COPD burden in Korea. Total COPD costs were comprised of three categories: direct medical, direct non-medical, and indirect costs. For direct medical costs, institutional investigation was performed at 13 medical facilities mainly based on the claims data. For direct non-medical and indirect costs, site-based surveys were administered to the COPD patients during routine visits. Total costs were estimated using the COPD population defined in the recent report. Results: The estimated total costs were approximately 1,245 million US dollar (1,408 billion Korean won). Direct medical costs comprised approximately 20% of the total estimated costs. Of these, formal medical costs held more than 80%. As direct non-medical costs, nursing costs made up the largest percentage (39%) of the total estimated costs. Costs for COPD-related loss of productivity formed four fifths of indirect costs, and accounted for up to 33% of the total costs. Conclusion: This study shows for the first time the direct and indirect costs of COPD in Korea. The total costs were enormous, and the costs of nursing and lost productivity comprised approximately 70% of total costs. The results provide insight for an effective allocation of healthcare resources and to inform establishment of strategies to reduce national burden of COPD.
Background: Understanding the burden of disease is important to establish cost-effective treatment strategies and to allocate healthcare resources appropriately. However, little reliable information is available regarding the overall economic burden imposed by chronic obstructive pulmonary disease (COPD) in Korea. Methods: This study is a multicenter observational research on the COPD burden in Korea. Total COPD costs were comprised of three categories: direct medical, direct non-medical, and indirect costs. For direct medical costs, institutional investigation was performed at 13 medical facilities mainly based on the claims data. For direct non-medical and indirect costs, site-based surveys were administered to the COPD patients during routine visits. Total costs were estimated using the COPD population defined in the recent report. Results: The estimated total costs were approximately 1,245 million US dollar (1,408 billion Korean won). Direct medical costs comprised approximately 20% of the total estimated costs. Of these, formal medical costs held more than 80%. As direct non-medical costs, nursing costs made up the largest percentage (39%) of the total estimated costs. Costs for COPD-related loss of productivity formed four fifths of indirect costs, and accounted for up to 33% of the total costs. Conclusion: This study shows for the first time the direct and indirect costs of COPD in Korea. The total costs were enormous, and the costs of nursing and lost productivity comprised approximately 70% of total costs. The results provide insight for an effective allocation of healthcare resources and to inform establishment of strategies to reduce national burden of COPD.
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문제 정의
Besides that, we should also consider direct informal, direct nonmedical, and indirect costs such as use of complementary and alternative medicines, transportation expenses, nursing care costs, and the loss of productivity for a thorough investigation of the total economic burden of COPD. Therefore, the purpose of the present study was to estimate in detail both direct and indirect costs and to inform establishment of efficient strategies to reduce the financial burden of COPD in Korea.
This study is a multicenter observational research on the economic burden of COPD in Korea. Total COPD costs were comprised of three categories.
제안 방법
All statistical analyses were performed using STATA/SE 13(StataCorp LP, College Station, TX, USA). Pearson’s chi-square test was used to compare the distribution of categorical variables.
The amount for CAMS(including non-prescription medicine, health functional food, fork medicine, and Chinese medical service) was aggregated with the expenses on medical and fitness equipment to make informal medical costs. Home care costs were calculated by multiplying home care rate according to the COPD severity, time cost per an hour, and 4 hours of care time a day. Nursing costs were calculated by adding time costs of family caregiver accompanying to home care cost.
Original Questionnaires included demographics, healthrelated quality of life using EQ-5D, informal medical costs, nursing fee, absenteeism, presenteeism, productivity loss, required time for visiting outpatient clinic, caregiver accompanying rate, and history of exacerbation. The amount for CAMS(including non-prescription medicine, health functional food, fork medicine, and Chinese medical service) was aggregated with the expenses on medical and fitness equipment to make informal medical costs.
The present study was designed to estimate the total costs of COPD in Korea based on the institutional investigation and patient surveys from 13 medical facilities using KHIRA database, Korea Health Panel data, and national statistics. The estimated total costs were approximately 1,245 million USD, which are enormous as much as 0.
To estimate costs for CAMS, medical equipment, nursing, and loss of productivity, site-based surveys were administered to the patients diagnosed with COPD during routine visits. The costs were added up according to the severity of airflow limitation and then the average cost per patient was derived.
대상 데이터
A total of 355 subjects from 13 medical facilities (2 primary, 11 secondary and tertiary facilities) permitted to participate in the present survey and were interviewed with questionnaires between June 2015 and October 2016. The inclusion criteria were same as above mentioned.
A total of 373 subjects have been recruited for this investigation from 13 medical facilities (1 primary, 6 secondary, and 6 tertiary facilities) since October 2013. The patients fulfilling all the following criteria were included: (1) having a physician diagnosis of COPD over 1 year, (2) aged 40 or over, and (3) without malignant diseases.
Of the 355 subjects participated in the survey, 74.4% were in their sixties and seventies; 91.8% were males. According to the COPD severity, 43 patients (12.
The patients fulfilling all the following criteria were included: (1) having a physician diagnosis of COPD over 1 year, (2) aged 40 or over, and (3) without malignant diseases. The number of study subjects was assigned according to the COPD severity to each of the facilities (10% for mild, 40% for moderate, 30% for severe, and 20% for very severe COPD). The severity of COPD was categorized by Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria based on the post-bronchodilator forced expiratory volume in one second (FEV1) as a percentage of predicted normal values (% predicted): mild, stage I, FEV1 ≥80%; moderate, stage II, 50%≤FEV1<80%; severe, stage III, 30%≤FEV1<50%; and very severe, stage IV, FEV1<30%.
데이터처리
Pearson’s chi-square test was used to compare the distribution of categorical variables.
이론/모형
Pearson’s chi-square test was used to compare the distribution of categorical variables. Because the statistics for continuous variables were not normally distributed based on the Shapiro-Wilk test, the nonparametric Kruskal-Wallis test was conducted. A value of p≤0.
성능/효과
Nursing costs made up the largest percentage (39%) of the total estimated costs. As indirect costs, costs for COPDrelated loss of productivity accounted for up to 33% of the total costs, and were highest in the moderate COPD group.
The present study had several limitations. First, this result was not the true economic burden of a total COPD population in Korea but an estimated burden using a relatively small group of COPD patients. However, we recruited patients from various medical facilities including primary, secondary, and tertiary care hospitals, and the estimation was based on the real world COPD population according to the KHIRA database.
In conclusion, the present study represented for the first time the direct and indirect economic burden of COPD in Korea. The total estimated costs were approximately 1,245 million USD (1,408 billion KRW), and the costs of nursing and lost productivity comprised approximately 70% of total costs.
참고문헌 (17)
1 Ehteshami-Afshar S FitzGerald JM Doyle-Waters MM Sadatsafavi M The global economic burden of asthma and chronic obstructive pulmonary disease Int J Tuberc Lung Dis 2016 20 11 23 26688525
2 Terzikhan N Verhamme KM Hofman A Stricker BH Brusselle GG Lahousse L Prevalence and incidence of COPD in smokers and non-smokers: the Rotterdam Study Eur J Epidemiol 2016 31 785 792 26946425
4 Yoo KH Kim YS Sheen SS Park JH Hwang YI Kim SH Prevalence of chronic obstructive pulmonary disease in Korea: the fourth Korean National Health and Nutrition Examination Survey, 2008 Respirology 2011 16 659 665 21342331
5 Kim C Yoo KH Rhee CK Yoon HK Kim YS Lee SW Health care use and economic burden of patients with diagnosed chronic obstructive pulmonary disease in Korea Int J Tuberc Lung Dis 2014 18 737 743 24903947
6 Rhee CK Yoon HK Yoo KH Kim YS Lee SW Park YB Medical utilization and cost in patients with overlap syndrome of chronic obstructive pulmonary disease and asthma COPD 2014 11 163 170 24111662
7 Lee JY Chon GR Rhee CK Kim DK Yoon HK Lee JH Characteristics of patients with chronic obstructive pulmonary disease at the first visit to a pulmonary medical center in Korea: the KOrea COpd Subgroup Study Team Cohort J Korean Med Sci 2016 31 553 560 27051239
8 Reilly MC Zbrozek AS Dukes EM The validity and reproducibility of a work productivity and activity impairment instrument Pharmacoeconomics 1993 4 353 365 10146874
10 Yoo KH Ahn HR Park JK Kim JW Nam GH Hong SK Burden of respiratory disease in Korea: an observational study on allergic rhinitis, asthma, COPD, and rhinosinusitis Allergy Asthma Immunol Res 2016 8 527 534 27582404
11 Patel JG Nagar SP Dalal AA Indirect costs in chronic obstructive pulmonary disease: a review of the economic burden on employers and individuals in the United States Int J Chron Obstruct Pulmon Dis 2014 9 289 300 24672234
12 Akazawa M Halpern R Riedel AA Stanford RH Dalal A Blanchette CM Economic burden prior to COPD diagnosis: a matched case-control study in the United States Respir Med 2008 102 1744 1752 18760581
13 Dal Negro RW Tognella S Tosatto R Dionisi M Turco P Donner CF Costs of chronic obstructive pulmonary disease (COPD) in Italy: the SIRIO study (social impact of respiratory integrated outcomes) Respir Med 2008 102 92 101 17881206
14 Gershon AS Guan J Victor JC Goldstein R To T Quantifying health services use for chronic obstructive pulmonary disease Am J Respir Crit Care Med 2013 187 596 601 23328526
15 Troosters T Gosselink R Janssens W Decramer M Exercise training and pulmonary rehabilitation: new insights and remaining challenges Eur Respir Rev 2010 19 24 29 20956162
16 Yoon HK Park YB Rhee CK Lee JH Oh YM Committee of the Korean COPD Guideline 2014 Summary of the chronic obstructive pulmonary disease clinical practice guideline revised in 2014 by the Korean Academy of Tuberculosis and Respiratory Disease Tuberc Respir Dis 2017 80 230 240
17 Chung SM Lee SY Evaluation of appropriate management of chronic obstructive pulmonary disease in Korea: based on Health Insurance Review and Assessment Service (HIRA) claims Tuberc Respir Dis 2017 80 241 246
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