Clinical and economic burden of COPD in a medicaid population.

Abstract

OBJECTIVE:

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.

• Authors: Anna O D'Souza, Manan Shah, Amol D Dhamane, Anand A Dalal
• Journal: COPD (COPD) Vol. 11 Issue 2 Pg. 212-20 (Apr 2014) ISSN: 1541-2563 [Electronic] England
• PMID: 24111752 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Aged
• Cost of Illness
• Ethnicity (statistics & numerical data)
• Female
• Health Care Costs
• Health Services (economics, statistics & numerical data)
• Hospitalization (economics, statistics & numerical data)
• Humans
• Male
• Medicaid
• Medicare
• Middle Aged
• Pulmonary Disease, Chronic Obstructive (economics, epidemiology, therapy)
• Retrospective Studies
• United States (epidemiology)
• White People (statistics & numerical data)