[Costs of the last hospitalization for patients with acute exacerbation of chronic obstructive pulmonary disease and patients with lung cancer].

ABSTRACT

OBJECTIVE: To examine the cost for patients who died in hospital with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) compared with those died with lung cancer, and to examine their variations. METHODS: A retrospective cohort study was performed. The patients who died in hospital between January in 2003 and December in 2007 were enrolled. Statistical analysis was performed using the SPSS 13.0. RESULTS: Totally 416 patients were enrolled, with 86 COPD patients and 330 lung cancer patients. Patients with COPD were older than those with lung cancer. The incidences of co-morbidities such as coronary artery disease, hypertension, cerebrovascular disease, respiratory failure and lung infection in AECOPD patients were higher than those in lung cancer patients. Second malignant neoplasm of important organs was found in 211 patients (63.94%) with lung cancer. In the last hospitalization, the total amount of direct medical costs was higher for patients with AECOPD than for patients with lung cancer [74 143 (102 608) RMB vs 37 810 (51 374) RMB], z = 2.48, P < 0.05, especially for the treatment cost [(19 324 (61 843) vs 5876 (9764), z = 4.55, P < 0.01] and the laboratory cost [7976 (18 397) vs 3397 (4096), z = 5.97, P < 0.01]. There was no significant difference in the constituents of the cost between COPD and lung cancer patients (chi(2) = 8.23, P > 0.05). The percentage of the drug cost to the total cost was the highest, followed by the treatment cost and the auxiliary examination cost. The ratio of the drug cost to the total cost was lower in COPD patients (37.2 +/- 12.6)% vs (53.8 +/- 17.6)%, t = 7.34, P < 0.01, while the constituent ratio of treatment cost was higher in COPD than in lung cancer patients CONCLUSIONS: There was significant variability in healthcare resource utilization between COPD and lung cancer patients in their last hospitalization of life, the main reason of which was the increased costs of maintenance of life.