Incidence and medical costs of chronic obstructive respiratory disease in Spanish hospitals: a retrospective database analysis

Abstract

Objective:This study aimed to assess the comorbidity profile, use of health care resources and med-ical costs of patients with chronic obstructive pulmonary disease (COPD) treated at the hospital levelin Spain.Methods:Admission records of patients with COPD and at least two admissions registered betweenJanuary 2016 and December 2020 were obtained from a Spanish hospital discharge database and ana-lyzed in a retrospective multicenter study.Results:95,140 patients met the inclusion criteria; 69.1% were males with a median age of 75years.Mean Charlson comorbidity index (CCI) was 1.9 in the index admission, increasing to 2.1 during thefollow-up period. An acute exacerbation of COPD was registered in 93.6% of patients in the indexadmission; other secondary diagnoses included respiratory failure (56.8%), essential hypertension(36.9%), hypercholesterolemia (26.7%) and diabetes (26.3%). The age-adjusted incidence rate of COPDwas 22.6 per 10,000 persons over the study period, decreasing significantly in the year 2020. Mortalityrate was 4.1% for COPD patients, increasing to 6.6% in the year 2020. The year 2020, 191 patients reg-istered a COVID-19 infection, with a mortality rate of 23.0%. Length of hospital stay, and intensive careunit (ICU) stay increased in the follow-up period versus the index admission, similar to admission costs.Mean admission cost wase3212 in the index admission, with cost increases being associated withage, length of stay, ICU stay and CCI.Conclusions:Patients'condition worsened significantly over the follow-up period, in terms of comor-bidity and dependence on respirator, with an increased mortality rate and higher admission costs.