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Revista americana de medicina respiratoria
versão On-line ISSN 1852-236X
Resumo
PASCANSKY, Daniel; SIVORI, Martín e CAPELLI, Luciano. Exacerbations of COPD hospitalized: Direct cost study in a public hospital of Buenos Aires City. Rev. am. med. respir. [online]. 2022, vol.22, n.4, pp.299-308. ISSN 1852-236X. http://dx.doi.org/10.56538/ramr.lybb1788.
There is not information about the annual and structure of costs of a hospitalization of COPD exacerbation in our country actually.
Objective:
To determine the structure of direct costs in hospitalized patients due to COPD exacerbations in a public hospital of Buenos Aires in 2018.
Methods:
Patients hospitalized of COPD exacerbation (GOLD) in 2018 were analyzed in our hospital. Direct costs were determined (financier perspective), due to modulation of the Health Ministry of Buenos Aires City Government, stratified by Intensive Care Unit hospitalization and in room at June 2021, in dollars (dol.), parity at June 30th 2021 was 1 dollar = 101,17$ (price Banco Nación).
Results:
26 patients were hospitalized: age 64 ± 9.56 years, male gender 73%, 61% actual smokers and 39% ex-smokers (101.8 ± 47.1 pack-y, social health assurance 31% (n = 8); FEV1% 31 median (23-42) and FEV1/FVC 0,46 ± 0,12. Ward length of hospitalization (median) was 1 day (1-1,75), 9 days in room (4-12), 13 days in UCI (11- 29,5) with mortality rate 23% (n = 6).
Final direct cost by patient was 1462,62 dol, median (IQR 25%-75%,763,85-2915,95),at 162,44 dol./day/patient. Total cost (n = 26) was 117 480 dol. UCI cost was median 9898,28 dol./patient (IQR 25%-75%, 6700,94-35 780,25). Final UCI total cost (n = 3) 75 942,3 dol.
Conclusion:
Patients with COPD exacerbation hospitalized were mainly males, sixty years old, heavy smokers and severe airway obstruction. With financier perspective, direct cost of hospitalization was 1462 dol./patient, almost seven times higher in UCI. Disease management program must be implemented to manage COPD, to identify patients at risk, to educate and to assure access to drugs.
Palavras-chave : COPD; Exacerbations; Hospitalizations; Costs; Expense.