TY - JOUR
T1 - Socioeconomic impact of asthma, chronic obstructive pulmonary disease and asthma-COPD overlap syndrome
AU - Kim, Jinhee
AU - Kim, Young Sam
AU - Kim, Kyungjoo
AU - Oh, Yeon Mok
AU - Yoo, Kwang Ha
AU - Rhee, Chin Kook
AU - Lee, Jin Hwa
N1 - Funding Information:
This work supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (2010-0027945).
Publisher Copyright:
© Journal of Thoracic Disease. All rights reserved.
PY - 2017/6/1
Y1 - 2017/6/1
N2 - Background: Asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) is defined as having both features of asthma and COPD, which are airway hyper-responsiveness and incompletely reversible airway obstruction. However, socioeconomic impact of ACOS have not been well appreciated. Methods: Adults with available wheezing history and acceptable spirometry were selected from the fourth Korean National Health and Nutrition Examination Survey (KNHANES IV) in 2007-2009. Their data were merged with the Korean National Health Insurance claim data. 'Asthma group' was defined as having self-reported wheezing history and FEV1/FVC ≥0.7, 'COPD group' was defined as having FEV1/FVC < 0.7 and no wheezing, 'ACOS group' was defined as having both wheezing and FEV1/FVC < 0.7, and 'no airway disease (NAD) group' was defined as having no wheezing and FEV1/FVC ≥0.7. Results: Among a total of 11,656 subjects, ACOS comprise 2.2%; COPD, 8.4%; asthma, 5.8% and NAD, 83.6%. Total length of healthcare utilization and medical costs of ACOS group was the top among four groups (P < 0.001), though inpatient medical cost was the highest in COPD group (P=0.025). Multiple linear regression analyses showed that ACOS group (β=12.63, P < 0.001) and asthma group (β=6.14, P < 0.001) were significantly associated with longer duration of healthcare utilization and ACOS group (β=350,475.88, P=0.008) and asthma group (β=386,876.81, P < 0.001) were associated with higher medical costs. Conclusions: This study demonstrated that ACOS independently influences healthcare utilization after adjusting several factors. In order to utilize limited medical resources efficiently, it may be necessary to find and manage ACOS patients.
AB - Background: Asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) is defined as having both features of asthma and COPD, which are airway hyper-responsiveness and incompletely reversible airway obstruction. However, socioeconomic impact of ACOS have not been well appreciated. Methods: Adults with available wheezing history and acceptable spirometry were selected from the fourth Korean National Health and Nutrition Examination Survey (KNHANES IV) in 2007-2009. Their data were merged with the Korean National Health Insurance claim data. 'Asthma group' was defined as having self-reported wheezing history and FEV1/FVC ≥0.7, 'COPD group' was defined as having FEV1/FVC < 0.7 and no wheezing, 'ACOS group' was defined as having both wheezing and FEV1/FVC < 0.7, and 'no airway disease (NAD) group' was defined as having no wheezing and FEV1/FVC ≥0.7. Results: Among a total of 11,656 subjects, ACOS comprise 2.2%; COPD, 8.4%; asthma, 5.8% and NAD, 83.6%. Total length of healthcare utilization and medical costs of ACOS group was the top among four groups (P < 0.001), though inpatient medical cost was the highest in COPD group (P=0.025). Multiple linear regression analyses showed that ACOS group (β=12.63, P < 0.001) and asthma group (β=6.14, P < 0.001) were significantly associated with longer duration of healthcare utilization and ACOS group (β=350,475.88, P=0.008) and asthma group (β=386,876.81, P < 0.001) were associated with higher medical costs. Conclusions: This study demonstrated that ACOS independently influences healthcare utilization after adjusting several factors. In order to utilize limited medical resources efficiently, it may be necessary to find and manage ACOS patients.
KW - Asthma
KW - Asthma COPD overlap syndrome (ACOS)
KW - Chronic obstructive pulmonary disease (COPD)
KW - Epidemiology
KW - Medical cost
UR - http://www.scopus.com/inward/record.url?scp=85021340762&partnerID=8YFLogxK
U2 - 10.21037/jtd.2017.05.07
DO - 10.21037/jtd.2017.05.07
M3 - Article
AN - SCOPUS:85021340762
VL - 9
SP - 1547
EP - 1556
JO - Journal of Thoracic Disease
JF - Journal of Thoracic Disease
SN - 2072-1439
IS - 6
ER -