Healthcare utilization and costs: a comparison between asthma, COPD, and asthma-COPD overlap syndrome = Healthcare utilization and costs: a comparison between asthma, COPD, and asthma-COPD overlap syndrome

다국어 초록 (Multilingual Abstract)

Background: Asthma-COPD overlap syndrome (ACOS) is defined as a syndrome that has both features of asthma and chronic obstructive pulmonary disease (COPD). Very few studies have assessed healthcare utilization and cost with a direct comparison between asthma, ACOS and COPD. Objective: To explore healthcare usage and related costs according to each airway diseases and to determine factors that could be associated with an increase of medical expense. Methods: We made a cohort of 21,076 subjects who aged over 40 years and underwent spirometry in the Korean National Health and Nutritional Survey (KNHANES) between 2007 and 2012. In same period, their data was linked with Korean National Health Insurance claims data by which healthcare utilization and costs were evaluated. Results: The subjects were grouped into COPD (n=1,933), asthma (n=1,755), ACOS (n=629), or normal lung function (n=16,759). During the study period, subjects with ACOS had higher healthcare costs than those with COPD, asthma or normal lung function. In addition, those with ACOS had higher number of outpatient visit and hospital day and higher rate of having medication for airway disease than those with COPD or asthma. Interestingly, after adjusting age, gender, income, medications, comorbidities and forced expiratory volume in 1 second, only COPD was significantly associated with increased medical costs over the median value of 354,150 won. Conclusions: Contrary to ACOS and asthma, COPD could be independently related with the increased medical expenses.