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Influence of deprivation on health care use, health care costs, and mortality in COPD

Influence of deprivation on health care use, health care costs, and mortality in COPD
Influence of deprivation on health care use, health care costs, and mortality in COPD

Background and aim: Deprivation is associated with the incidence of COPD, but its independent impact on clinical outcomes is still relatively unknown. This study aimed to explore the influence of deprivation on health care use, costs, and survival. Methods: A total of 424 outpatients with COPD were assessed for deprivation across two hospitals. The English Index of Multiple Deprivation (IMD) was used to establish a deprivation score for each patient. The relationship between deprivation and 1-year health care use, costs, and mortality was examined, controlling for potential confounding variables (age, malnutrition risk, COPD severity, and smoking status). Results: IMD was significantly and independently associated with emergency hospitalization (β-coefficient 0.022, SE 0.007; p=0.001), length of hospital stay, secondary health care costs (β-coefficient £101, SE £30; p=0.001), and mortality (HR 1.042, 95% CI 1.015–1.070; p=0.002). IMD was inversely related to participation in exercise rehabilitation (OR 0.961, 95% CI 0.930–0.994; p=0.002) and secondary care appointments. Deprivation was also significantly related to modifiable risk factors (smoking status and malnutrition risk). Conclusion: Deprivation in patients with COPD is associated with increased emergency health care use, health care costs, and mortality. Tackling deprivation is complex; however, strategies targeting high-risk groups and modifiable risk factors, such as malnutrition and smoking, could reduce the clinical and economic burden.

COPD, Deprivation, Economics, Socioeconomic
1176-9106
1289-1296
Collins, Peter F.
580e9a16-a6e4-4466-8a36-6db713f716c4
Stratton, Rebecca J.
c6a5ead1-3387-42e7-8bea-5ac7d969d87b
Kurukulaaratchy, Ramesh J.
9c7b8105-2892-49f2-8775-54d4961e3e74
Elia, Marinos
964bf436-e623-46d6-bc3f-5dd04c9ef4c1
Collins, Peter F.
580e9a16-a6e4-4466-8a36-6db713f716c4
Stratton, Rebecca J.
c6a5ead1-3387-42e7-8bea-5ac7d969d87b
Kurukulaaratchy, Ramesh J.
9c7b8105-2892-49f2-8775-54d4961e3e74
Elia, Marinos
964bf436-e623-46d6-bc3f-5dd04c9ef4c1

Collins, Peter F., Stratton, Rebecca J., Kurukulaaratchy, Ramesh J. and Elia, Marinos (2018) Influence of deprivation on health care use, health care costs, and mortality in COPD. International Journal of COPD, 13, 1289-1296. (doi:10.2147/COPD.S157594).

Record type: Article

Abstract

Background and aim: Deprivation is associated with the incidence of COPD, but its independent impact on clinical outcomes is still relatively unknown. This study aimed to explore the influence of deprivation on health care use, costs, and survival. Methods: A total of 424 outpatients with COPD were assessed for deprivation across two hospitals. The English Index of Multiple Deprivation (IMD) was used to establish a deprivation score for each patient. The relationship between deprivation and 1-year health care use, costs, and mortality was examined, controlling for potential confounding variables (age, malnutrition risk, COPD severity, and smoking status). Results: IMD was significantly and independently associated with emergency hospitalization (β-coefficient 0.022, SE 0.007; p=0.001), length of hospital stay, secondary health care costs (β-coefficient £101, SE £30; p=0.001), and mortality (HR 1.042, 95% CI 1.015–1.070; p=0.002). IMD was inversely related to participation in exercise rehabilitation (OR 0.961, 95% CI 0.930–0.994; p=0.002) and secondary care appointments. Deprivation was also significantly related to modifiable risk factors (smoking status and malnutrition risk). Conclusion: Deprivation in patients with COPD is associated with increased emergency health care use, health care costs, and mortality. Tackling deprivation is complex; however, strategies targeting high-risk groups and modifiable risk factors, such as malnutrition and smoking, could reduce the clinical and economic burden.

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COPD-157594-influence-of-deprivation-on-healthcare-use--healthcare-costs_041818
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Accepted/In Press date: 9 February 2018
e-pub ahead of print date: 19 April 2018
Keywords: COPD, Deprivation, Economics, Socioeconomic

Identifiers

Local EPrints ID: 420422
URI: http://eprints.soton.ac.uk/id/eprint/420422
ISSN: 1176-9106
PURE UUID: 08b56ea1-c9bb-49fe-a706-ff8acd9dd8a0
ORCID for Ramesh J. Kurukulaaratchy: ORCID iD orcid.org/0000-0002-1588-2400

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Date deposited: 08 May 2018 16:30
Last modified: 18 Feb 2021 16:54

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