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Clinical and economic burden of COPD in a medicaid population.

AbstractOBJECTIVE:
To evaluate the clinical and economic burden of COPD patients to Medicaid.
STUDY DESIGN:
Retrospective, observational matched cohort design.
METHODS:
We calculated the incremental costs incurred and medical resources used by COPD patients relative to those without COPD. Data were obtained from 8 Medicaid states during 2003-2007. COPD patients were defined as Medicaid beneficiaries ≥40 years with a COPD diagnosis (ICD-9 CM: 491.xx, 492.xx, 496.xx) and treated with maintenance drugs for COPD. Patients were matched (1:3) to Medicaid beneficiaries without a COPD diagnosis on age, gender, race, index year, Medicare/Medicaid dual eligibility, and use of long-term care. Results were stratified by Medicare/Medicaid dual eligibility status and race.
RESULTS:
A total of 10,221 COPD and 30,663 non-COPD patients were included. Cohorts were on average 65 years of age, 80% White, and 64.8% having Medicare/Medicaid dual eligibility. Inpatient hospitalizations and home healthcare visits/durable medical equipment were primary drivers of incremental medical costs. COPD patients were more than twice as likely to have a hospitalization (odds ratio [95% confidence interval] = 2.32 [2.19, 2.45]) or home healthcare visit/durable medical equipment (2.95 [2.82, 3.08]) compared to non-COPD patients. Medicaid incurred $2118/year in incremental costs due to COPD. On average, incremental costs were 7 times greater for non-dual-eligible patients ($4917) compared to dual-eligible patients ($667), and were more than double for Blacks compared to Whites ($4141 vs $1593).
CONCLUSION:
COPD imposes a substantial economic and clinical burden on the Medicaid program; this burden differs by dual eligibility status and race.
AuthorsAnna O D'Souza, Manan Shah, Amol D Dhamane, Anand A Dalal
JournalCOPD (COPD) Vol. 11 Issue 2 Pg. 212-20 (Apr 2014) ISSN: 1541-2563 [Electronic] England
PMID24111752 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Topics
  • Aged
  • Cost of Illness
  • Ethnic Groups (statistics & numerical data)
  • European Continental Ancestry Group (statistics & numerical data)
  • Female
  • Health Care Costs
  • Health Services (economics, utilization)
  • Hospitalization (economics, statistics & numerical data)
  • Humans
  • Male
  • Medicaid
  • Medicare
  • Middle Aged
  • Pulmonary Disease, Chronic Obstructive (economics, epidemiology, therapy)
  • Retrospective Studies
  • United States (epidemiology)

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