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The Economic Effect of Early Management in Patients with Early Chronic Obstructive Pulmonary Disease: Results from a Population-Based Nationwide Survey

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Abstract

Purpose

The economic effect of regular follow-up and early management in patients with early chronic obstructive pulmonary disease (COPD) has not yet been clarified. Therefore, this study aimed to estimate the economic effect of regular follow-up and early management in these patients.

Methods

Patients with early COPD were identified from the Korea National Health and Nutrition Examination Survey. We analyzed medical utilization and cost for 2 years without any missing data by using the Korean National Health Insurance data. Patients with routine healthcare maintenance were defined as, after diagnosis, those with regular visits to the hospital and receiving early management of COPD.

Results

Among 1204 patients with early COPD, the patients who were classified as the group with routine healthcare maintenance (69/146; 47.3%) and the group with intermittent healthcare user (79/1058; 7.5%) visited to hospital for the next 2 years. The patients with routine healthcare maintenance had lower cost of inpatient service and frequencies of emergency room (ER) visit and intensive care unit (ICU) admission than intermittent healthcare users (cost of inpatient service, $4595 vs. $4953 per person; ER visit, 7.2 vs. 11.5; ICU admission, 4.3 vs. 7.7). Even in patients with COPD and FEV1 ≥ 80, early intervention through follow-up reduced the cost of inpatient service because these patients could have had less severe acute exacerbations than intermittent healthcare users.

Conclusion

Patients with early COPD, even those with FEV1 ≥ 80, need regular follow-up for early management and disease control as well as for reducing the socioeconomic burden of the disease.

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Abbreviations

COPD:

Chronic obstructive pulmonary disease

FEV1 :

Forced expiratory volume in 1 s

FVC:

Forced vital capacity

KNHANES:

The Korea National Health and Nutrition Examination Survey

KNHI:

The Korean National Health Insurance

PFT:

Pulmonary function test

ICD-10:

The International Classification of Diseases-Tenth Revision

ER:

Emergency room

ICU:

Intensive care unit

USD:

US dollars

KRW:

Korean won

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Acknowledgements

This study was supported by a Grant (No. 2014P3300300) from the Korea Centers for Disease Control and Prevention. This study was supported by COPD cohort data of HIRA.

Funding

This study was supported by a grant (2014P3300300) from the Korea Centers for Disease Control and Prevention.

Author information

Author notes

  1. Young Seok Lee and Kyung Hoon Min are contributed equally to this work.

Authors and Affiliations

  1. Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Korea University Medical Center, Guro Hospital, Seoul, Republic of Korea

    Young Seok Lee & Kyung Hoon Min

  2. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

    Chin Kook Rhee

  3. Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

    Yong Hyun Kim

  4. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Seong Yong Lim

  5. Division of Respiratory Medicine, Department of Internal Medicine, Dong-A University College of Medicine, Dong-A University Medical Center, Busan, Republic of Korea

    Soo-Jung Um

  6. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea

    Chang-Hoon Lee

  7. Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, Sacred Heart Hospital, Hallym University, Hallym University College of Medicine, Anyang, Republic of Korea

    Ki-Suck Jung

  8. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Konkuk University School of Medicine, 120 Neungdong-ro, Gwangjin-gu, 05029, Seoul, Republic of Korea

    Kwang Ha Yoo

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  1. Young Seok Lee
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Contributions

LYS, MKH, YKH: Conception and design of the study; LYS, MKH, RCK, JKS, YKH: Data generation (When applicable); LYS, MKH, RCK, KYH, LSY, USJ, LCH, JKS, YKH: Analysis and Interpretation of the data; LYS, MKH, RCK, KYH, LSY, USJ, LCH, JKS, YKH: Preparation or critical revision of the manuscript.

Corresponding author

Correspondence to Kwang Ha Yoo.

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The authors of this study declare that they have no competing interests in regard to this manuscript.

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Lee, Y.S., Min, K.H., Rhee, C.K. et al. The Economic Effect of Early Management in Patients with Early Chronic Obstructive Pulmonary Disease: Results from a Population-Based Nationwide Survey. Lung 197, 303–313 (2019). https://doi.org/10.1007/s00408-019-00208-5

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