Cost of Severe Chronic Obstructive Pulmonary Disease Exacerbations in a High Burden Region in North India

Background: Data on costs of acute exacerbations of COPD (AECOPD) in low-income countries are sparse. We conducted a prospective survey to assess direct and indirect costs of severe AECOPD in a tertiary care setting in a high prevalence area of North India. Methods: We conducted face-to-face surveys...

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Autores principales:	Parvaiz A. Koul, Aqsa Amin Nowshehr, Umar H. Khan, Rafi A. Jan, S. U. Shah
Formato:	article
Lenguaje:	EN
Publicado:	Ubiquity Press 2019
Materias:	Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/82110b9d5ee84166a3a981126e83ae04
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spelling	oai:doaj.org-article:82110b9d5ee84166a3a981126e83ae042021-12-02T02:17:15ZCost of Severe Chronic Obstructive Pulmonary Disease Exacerbations in a High Burden Region in North India2214-999610.5334/aogh.2423https://doaj.org/article/82110b9d5ee84166a3a981126e83ae042019-01-01T00:00:00Zhttps://annalsofglobalhealth.org/articles/2423https://doaj.org/toc/2214-9996Background: Data on costs of acute exacerbations of COPD (AECOPD) in low-income countries are sparse. We conducted a prospective survey to assess direct and indirect costs of severe AECOPD in a tertiary care setting in a high prevalence area of North India. Methods: We conducted face-to-face surveys using a semi-structured questionnaire among a convenience sample of 129 consenting patients admitted with AECOPD. Data were collected on out-of-pocket costs of hospitalization, consultation, medications, diagnostics, transportation, lodging, and missed work days for self and their attendants. Out-of-pocket costs were supplemented with World Health Organization-CHOICE estimates. Missed work-days were valued on per capita national income (Indian Rupees [INR] 68,748, US$1,145.8). Median total cost per exacerbation episode was INR 44,390 (Inter-quartile range [IQR]: INR 33,354–63,642; US$739.8, IQR: 555.9–1060.7). Hospital costs constituted the largest component of the costs (71%) followed by other costs directly borne by the patient himself (29%), medicine costs (14%), transportation charges (2%) and diagnostic tests (3%). Indirect costs to caregivers (median INR 1,544, IQR: INR 0–17,370 INR; US$25.7, IQR: US$0–289.5), calculated as financial loss due to missed work days, accounted for 4% of the total cost. Expenses were covered by family members in all but 11 patients. Conclusions: AECOPD in India are associated with substantial costs and strategies to reduce the burden of disease such as smoking cessation, influenza and pneumococcal vaccination, etc should be aggressively pursued.Parvaiz A. KoulAqsa Amin NowshehrUmar H. KhanRafi A. JanS. U. ShahUbiquity PressarticleInfectious and parasitic diseasesRC109-216Public aspects of medicineRA1-1270ENAnnals of Global Health, Vol 85, Iss 1 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270
spellingShingle	Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270 Parvaiz A. Koul Aqsa Amin Nowshehr Umar H. Khan Rafi A. Jan S. U. Shah Cost of Severe Chronic Obstructive Pulmonary Disease Exacerbations in a High Burden Region in North India
description	Background: Data on costs of acute exacerbations of COPD (AECOPD) in low-income countries are sparse. We conducted a prospective survey to assess direct and indirect costs of severe AECOPD in a tertiary care setting in a high prevalence area of North India. Methods: We conducted face-to-face surveys using a semi-structured questionnaire among a convenience sample of 129 consenting patients admitted with AECOPD. Data were collected on out-of-pocket costs of hospitalization, consultation, medications, diagnostics, transportation, lodging, and missed work days for self and their attendants. Out-of-pocket costs were supplemented with World Health Organization-CHOICE estimates. Missed work-days were valued on per capita national income (Indian Rupees [INR] 68,748, US$1,145.8). Median total cost per exacerbation episode was INR 44,390 (Inter-quartile range [IQR]: INR 33,354–63,642; US$739.8, IQR: 555.9–1060.7). Hospital costs constituted the largest component of the costs (71%) followed by other costs directly borne by the patient himself (29%), medicine costs (14%), transportation charges (2%) and diagnostic tests (3%). Indirect costs to caregivers (median INR 1,544, IQR: INR 0–17,370 INR; US$25.7, IQR: US$0–289.5), calculated as financial loss due to missed work days, accounted for 4% of the total cost. Expenses were covered by family members in all but 11 patients. Conclusions: AECOPD in India are associated with substantial costs and strategies to reduce the burden of disease such as smoking cessation, influenza and pneumococcal vaccination, etc should be aggressively pursued.
format	article
author	Parvaiz A. Koul Aqsa Amin Nowshehr Umar H. Khan Rafi A. Jan S. U. Shah
author_facet	Parvaiz A. Koul Aqsa Amin Nowshehr Umar H. Khan Rafi A. Jan S. U. Shah
author_sort	Parvaiz A. Koul
title	Cost of Severe Chronic Obstructive Pulmonary Disease Exacerbations in a High Burden Region in North India
title_short	Cost of Severe Chronic Obstructive Pulmonary Disease Exacerbations in a High Burden Region in North India
title_full	Cost of Severe Chronic Obstructive Pulmonary Disease Exacerbations in a High Burden Region in North India
title_fullStr	Cost of Severe Chronic Obstructive Pulmonary Disease Exacerbations in a High Burden Region in North India
title_full_unstemmed	Cost of Severe Chronic Obstructive Pulmonary Disease Exacerbations in a High Burden Region in North India
title_sort	cost of severe chronic obstructive pulmonary disease exacerbations in a high burden region in north india
publisher	Ubiquity Press
publishDate	2019
url	https://doaj.org/article/82110b9d5ee84166a3a981126e83ae04
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Cost of Severe Chronic Obstructive Pulmonary Disease Exacerbations in a High Burden Region in North India

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