Association of cardiovascular risk profile with healthcare expenditure and resource utilization in chronic obstructive pulmonary disease, with and without atherosclerotic cardiovascular disease.
ASCVD
COPD
Healthcare expenditure
Medications
Journal
American journal of preventive cardiology
ISSN: 2666-6677
Titre abrégé: Am J Prev Cardiol
Pays: Netherlands
ID NLM: 101769122
Informations de publication
Date de publication:
Sep 2020
Sep 2020
Historique:
received:
13
05
2020
revised:
11
08
2020
accepted:
25
08
2020
entrez:
30
7
2021
pubmed:
31
7
2021
medline:
31
7
2021
Statut:
epublish
Résumé
Atherosclerotic cardiovascular disease (ASCVD) and chronic obstructive pulmonary disease (COPD) are among the leading causes of morbidity, mortality, and economic burden in the United States (US). While previous reports have shown that an optimal cardiovascular risk factor (CRF) profile is associated with improved outcomes among COPD patients, the impact of ASCVD and CRF on healthcare costs and resource utilization is not well described. The Medical Expenditure Panel Survey (MEPS) database was used from 2011 to 2016 to study healthcare expenditure for COPD patients with and without ASCVD and across CRF profiles in a nationally representative population of adults in the United States. The study population consisted of 14,807 adults with COPD, representing 28 million cases annually. Presence of ASCVD was associated with higher reported expenditure across the spectrum of CRF profiles among those with COPD. On average, after adjusting for confounders, presence of ASCVD represented a mean difference per capita of $5438 (95% CI $4121 - $6754; p < 0.001). Mean per capita expenditures were significantly higher comparing poor vs optimal CRF profiles, with marginal expenditures of $8552 and $6531 among those with and without ASCVD, respectively. When comparing individuals with ASCVD and poor CRF profile versus individuals without ASCVD and optimal CRF profile, those in the latter group used 13% fewer prescription medications and required 24% fewer hospitalizations. Furthermore, an optimal CRF profile was associated with lower odds of most sources of healthcare utilization regardless of ASCVD status. An absence of ASCVD and a favorable CRF profile was associated with lower healthcare expenditure and resource utilization among patients with COPD. These results provide robust estimates for potential healthcare savings as preemptive strategies continue to become integrated into new healthcare delivery models, for increased awareness and the need for improvement of CRF profiles among high-risk patients.
Identifiants
pubmed: 34327464
doi: 10.1016/j.ajpc.2020.100084
pii: S2666-6677(20)30084-2
pmc: PMC8315593
doi:
Types de publication
Journal Article
Langues
eng
Pagination
100084Subventions
Organisme : NCATS NIH HHS
ID : UL1 TR001863
Pays : United States
Informations de copyright
© 2020 The Authors.
Déclaration de conflit d'intérêts
Dr. Nasir is supported by the Katz Academy for Translational Research.
Références
Respir Med. 2011 Oct;105(10):1516-22
pubmed: 21684731
Int J Chron Obstruct Pulmon Dis. 2009;4:337-49
pubmed: 19802349
Natl Vital Stat Rep. 2019 Jun;68(9):1-77
pubmed: 32501199
J Am Diet Assoc. 2010 Dec;110(12):1852-89
pubmed: 21111095
Ther Adv Respir Dis. 2018 Jan-Dec;12:1753465817750524
pubmed: 29355081
Chest. 2015 Jul;148(1):138-150
pubmed: 25675282
MMWR Morb Mortal Wkly Rep. 2015 Mar 27;64(11):289-95
pubmed: 25811677
Clinicoecon Outcomes Res. 2013 Jun 17;5:235-45
pubmed: 23818799
Eur Respir J. 2008 Oct;32(4):962-9
pubmed: 18579551
Circulation. 2020 Mar 3;141(9):e139-e596
pubmed: 31992061
Chest. 2015 Jan;147(1):31-45
pubmed: 25058738