Midtveisevaluering - Marta Erdal
PhD project: Chronic Obstructive Pulmonary Disease (COPD): exacerbations and costs.
In my PhD project, we are aiming to estimate the prevalence and costs of COPD exacerbations both in a general population and in a hospital-recruited sample. Further, we want to evaluate the burden related to reduced working ability associated with COPD both nationally and internationally.
We have found that in a general population the burden of COPD is significantly lower than in a hospital-recruited sample, both when it comes to exacerbation prevalence, absence from work and total costs. Internationally, having COPD was associated with a 43% increased risk of unemployment, but the predictors of unemployment differed between high-income and low-to-middle income countries. Further, we have found that the average annual disease-related costs for a COPD patient from the hospital sample was nearly twice as high as for a COPD case from the population sample, and nearly four times as high as for a control subject. Severe exacerbations were an important cost driver for the direct costs in both COPD groups.
In conclusion, COPD is a multifaceted disease that occurs with different burden in different patient groups. When performing studies on COPD patients from a hospital sample one should know that such samples give rise to a higher burden that what is the case in general populations. Both the burden on each patient and on society is high. Smoking cessation, pulmonary rehabilitation, and early intervention against exacerbations are important when trying to minimize the personal, the economic and the societal burden of this highly prevalent disease.