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This Article Full Text (PDF) Correction All Versions of this Article: chest.07-2317v1 134/1/14    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Du, D. Articles by Scharf, S. M Search for Related Content PubMed PubMed Citation Articles by Du, D. Articles by Scharf, S. M Related Content Related Editorial

Burden of Concomitant Asthma and COPD in a Medicaid Population

Dongyi Du, MS, Pharmaceutical Health Services Research Department, University of Maryland School of Pharmacy, Email ddu001@umaryland.edu; Manabu O. Akazawa, PhD, University of North Carolina at Chapel Hill, Email: manabu.o.akazawa@gsk.com; Christopher. M. Blanchette, PhD, GlaxoSmithKline, Inc., christopher.m.blanchette@gsk.com; Jingshu Wang, PhD, University of Maryland School of Pharmacy, Email: jwang1@rx.umaryland.edu; Douglas W. Mapel, MD, MPH, Lovelace Clinic Foundation, Email: dmapel@comcast.net; Anand Dalal, Ph.D., M.B.A., GlaxoSmithKline, Inc., Email: Anand.a.dalal@gsk.com; Steven M Scharf MD PhD, University of Maryland, Baltimore, Email: sscharf@medicine.umaryland.edu

fshaya{at}rx.umaryland.edu

Abstract

BackgroundAsthma and COPD can significantly affect patients and pose a substantial economic burden for both patients and managed care plans. This study compares utilization outcomes in patients with asthma, COPD or co-occurring asthma and COPD in a Medicaid population and assesses the incremental burden of COPD in patients with asthma.

MethodsWe queried medical claims of Medicaid patients aged 40-64 years with asthma and/or COPD filed between 1/1/01 and 12/31/03, from encounter data. COPD patients were identified based on at least one claim with ICD-9 codes 491, 492, 496, and asthma patients on the basis of ICD-9 code 493 as diagnosis. We analyzed annual utilization and cost of hospitalizations, physician, and outpatient services attributable to asthma and/or COPD.

ResultsThe analysis included a total of 3,072 asthma, 3,455 COPD and 2,604 COPD/asthma patients. COPD/asthma co-occurring disease has higher utilization of any service type than either disease alone. Compared with asthma patients, COPD patients were 16% and 51% more likely to use physician (OR=1.16, 95% CI: 1.01-1.34) and inpatient services (OR=1.51 95% CI: 1.31-1.74), respectively; and 60% less likely to use outpatient services (OR=0.40 95% CI: 0.35-0.46). Compared with asthma patients, COPD patients, and COPD/asthma co-occurring patients cost 50% (OR=1.50, 95% CI: 1.3-1.74) and 5 times (OR=5.25, 95% CI: 4.59-6.02) more for total medical services respectively.

ConclusionOur data suggest that patients with COPD and co-occurring COPD/asthma were sicker and used more medical services than asthma patients. The incremental burden of COPD to patients with asthma is significant.

Key Words: Asthma • COPD • Medical utilization • Medicaid

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Coexisting Asthma and COPD: Confused Clinicians or Poor Prognosticator?

David M. Mannino
Chest 2008 134: 1-2. [Full Text] [PDF]