The Annual Cost of Chronic Obstructive Pulmonary Disease to the UK's National Health Service
Julian F. Guest
Objective: The objective of this study was to estimate the annual resource use and corresponding costs (at 1996/97 prices) to the UK's National Health Service (NHS) arising from the management of chronic obstructive pulmonary disease (COPD). Design and Setting: A subgroup analysis was performed on a previously published prevalence-based burden of illness analysis. The analysis estimated the annual cost to the NHS of managing all community-acquired lower respiratory tract infections (LRTIs) during 1992/93. As there have been few innovations in COPD management over the last 5 years, this subgroup analysis indicates the order of magnitude of annual resource use and corresponding costs. Results: The subgroup analysis estimated that the NHS spends Lstg 817.5 million annually managing COPD. Inpatient stay for COPD cost Lstg 243.4 million annually, general practitioner (GP) consultations cost Lstg 236.5 million and outpatient clinic visits Lstg 35.0 million. Drugs prescribed by GPs cost an estimated Lstg 116.9 million with another Lstg 8.9 million attributable to hospital prescribing. GP-initiated and inpatient-based diagnostic tests accounted for Lstg 132.7 million and Lstg 11.2 million, respectively. Community nursing visits cost Lstg 2.0 million and NHS transport Lstg 18.4 million. Conclusions: Hospitalisation accounts for approximately 35% of the expenditure. However, less than 2% of patients with COPD are admitted into hospital. The cost of a hospital admission to manage COPD was an estimated Lstg 3000. In contrast, the mean annual community cost was Lstg 100 per patient. Therefore, management strategies that reduce either the number of hospital admissions or the length of hospital stay could potentially reduce direct healthcare costs.
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