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  • Title: [Comparison of outpatient and inpatient costs of moderate and severe exacerbations of chronic obstructive pulmonary disease in Poland].
    Author: Jahnz-Rózyk K, Targowski T, From S.
    Journal: Pneumonol Alergol Pol; 2008; 76(6):426-31. PubMed ID: 19173191.
    Abstract:
    INTRODUCTION: The aim of the study was to examine the direct and indirect costs of COPD exacerbations under usual clinical practice in primary and secondary care from a societal perspective in Poland. MATERIAL AND METHODS: An observational, prospective study was conducted among patients with exacerbation of moderate or severe COPD. Seventy-three patients were included in the study - 39 treated in hospital (HC) and 34 treated in ambulatory care (AC). The direct costs included the cost of drugs, diagnostic tests, in-hospital and outpatient care. The indirect costs included costs of transportation to the health-care provider and work days lost. RESULTS: The mean duration of COPD exacerbation did not differ significantly between the groups [HC: 11.2 (CI 95%: 9.6-12.8) days; AC: 10.8 (CI 95%: 9.1-12.1); p > 0.05]. The total health-care cost per exacerbation was EUR 1197 (4137.9 PLN) in secondary care (the HC group), and it was 6 times higher than the total cost of exacerbation in primary care (the AC group) - EUR 199.8 (446.9 PLN). The costs of drugs and diagnostic tests were significantly higher in the HC group than in the AC group; however, it was the cost of in-hospital stay and medical visits in the HC group that most influenced expenditure related to COPD exacerbations, as they were 27 times higher than in the AC group. CONCLUSIONS: In Poland the costs of COPD exacerbation managed in secondary care are 6-fold higher than in primary care. Therefore, the decisions about admission of patients with COPD exacerbation to hospital should be made carefully.
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