Healthcare Costs of Patients With Chronic Obstructive Pulmonary Disease in Denmark – Hospital Treated Versus Primary Care Only
Abstract Background: Many patients are treated for chronic obstructive pulmonary disease (COPD) in primary care but have never received COPD treatment in secondary care. They are seldom included in COPD cost studies but may account for a substantial proportion of the total costs.Objective: To estimate and specify the total healthcare costs of patients treated for COPD in Denmark comparing those who have- and have not had COPD treatment in secondary care.Setting: Denmark, population 5.7 million citizens.Methods: Via national registers, we specified the total healthcare costs of all +30-years-old current users of respiratory pharmaceuticals. We then compared those with at least one episode of hospital treatment for COPD (=secondary-care) to those with no hospital treatment for COPD but who redeem prescriptions specifically for COPD (=primary-care-only).Results: Among totally 329,428 users of respiratory drugs, we identified 46,084 with secondary-care- and 68,471 with primary-care-only COPD. Primary-care-only accounted for 40% of the two groups’ total healthcare costs. The age- and gender-adjusted coefficient relating the individual total costs secondary-care versus primary-care-only was 2.19. The individual costs ranged widely and overlapped considerably (p25-75: secondary-care 2,175€ - 12,625€, primary-care-only 1,110€ - 4,350€). Hospital treatment accounted for most of the total cost (secondary-care 78%, primary-care-only 62%; coefficient 2.81), pharmaceuticals (secondary-care 16%, primary-care-only 27%; coefficient 1.28), and primary care costs (secondary-care 6%, primary-care-only 11%; coefficient 1.13).Conclusion: Healthcare cost estimators and planners should consider the substantial volume of patients who are treated for COPD in primary care, but do not appear in hospital statistics.