Original Articles
Costs of Chronic Obstructive Pulmonary Disease in Spain: Estimation From a Population-Based Study
J.F. Masaa,
, V. Sobradillob, C. Villasantec, C.A. Jiménez-Ruizd, L. Fernández-Faue, J.L. Viejof, M. Miravitllesg
Corresponding author
a Sección de Neumología, Hospital San Pedro de Alcántara, Cáceres, Spain
b Unidad de Patología Respiratoria, Hospital de Cruces, Baracaldo, Vizcaya, Spain
c Servicio de Neumología, Hospital La Paz, Madrid, Spain
d Servicio de Neumología, Hospital de la Princesa, Madrid, Spain
e Servicio de Cirugía Torácica, Hospital de la Princesa, Madrid, Spain
f Servicio de Neumología, Hospital General Yagüe, Burgos, Spain
g Servicio de Neumología, Hospital Clínic (IDIBAPS), Barcelona, Spain
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"apellidos" => "Masa" "email" => array:1 [ 0 => "fmasa@separ.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] 1 => array:3 [ "nombre" => "V." "apellidos" => "Sobradillo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] 2 => array:3 [ "nombre" => "C." "apellidos" => "Villasante" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] ] ] 3 => array:3 [ "nombre" => "C.A." "apellidos" => "Jiménez-Ruiz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff4" ] ] ] 4 => array:3 [ "nombre" => "L." 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"apellidos" => "Miravitlles" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">g</span>" "identificador" => "aff7" ] ] ] ] "afiliaciones" => array:7 [ 0 => array:3 [ "entidad" => "Sección de Neumología, Hospital San Pedro de Alcántara, Cáceres, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Unidad de Patología Respiratoria, Hospital de Cruces, Baracaldo, Vizcaya, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] 2 => array:3 [ "entidad" => "Servicio de Neumología, Hospital La Paz, Madrid, Spain" "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] 3 => array:3 [ "entidad" => "Servicio de Neumología, Hospital de la Princesa, Madrid, Spain" "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff4" ] 4 => array:3 [ "entidad" => "Servicio de Cirugía Torácica, Hospital de la Princesa, Madrid, Spain" "etiqueta" => "<span class="elsevierStyleSup">e</span>" "identificador" => "aff5" ] 5 => array:3 [ "entidad" => "Servicio de Neumología, Hospital General Yagüe, Burgos, Spain" "etiqueta" => "<span class="elsevierStyleSup">f</span>" "identificador" => "aff6" ] 6 => array:3 [ "entidad" => "Servicio de Neumología, Hospital Clínic (IDIBAPS), Barcelona, Spain" "etiqueta" => "<span class="elsevierStyleSup">g</span>" "identificador" => "aff7" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dr. J.F. Masa Jiménez. Rafael Alberti, 12. 1005 Cáceres. España" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2003-03-04" "fechaAceptado" => "2003-10-07" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec153273" "palabras" => array:6 [ 0 => "COPD" 1 => "Costs" 2 => "Pharmacoeconomics" 3 => "Treatment" 4 => "Diagnosis" 5 => "Epidemiology" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec153272" "palabras" => array:6 [ 0 => "EPOC" 1 => "Costes" 2 => "Farmacoeconomía" 3 => "Tratamiento" 4 => "Diagnóstico" 5 => "Epidemiología" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">In the studies carried out to date, the cost of chronic obstructive pulmonary disease (COPD) may have been overestimated due to the inclusion of previously diagnosed patients seeking medical attention for their symptoms. As a result, the severity of the cases included in these studies may have been greater than in an unselected sample of the general population. The aim of the present study was to estimate the direct cost of COPD on the basis of a representative sample of the overall Spanish population between 40 and 69 years of age (from the IBERPOC study).</p> <span class="elsevierStyleSectionTitle">Method</span><p class="elsevierStyleSimplePara elsevierViewall">The cost was evaluated retrospectively by means of a questionnaire completed by the 363 patients with COPD from the IBERPOC study with questions referring to the previous year. Standardized spirometry was performed on all the patients by a pneumologist in each of the 7 geographical areas in which the study was carried out.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">Hospitalization accounted for the greatest expenditure (41% of total), followed by drug therapy (37%). The cost was €98.39 per patient, and €909.50 per previously diagnosed patient. The cost per person of severe COPD was more than 3 times that of moderate COPD and more than 7 times that of mild COPD. The estimated annual cost of COPD in Spain was €238.82 million (for 1997).</p> <span class="elsevierStyleSectionTitle">Conclusion</span><p class="elsevierStyleSimplePara elsevierViewall">The present study, which was the first to estimate the cost of COPD in a representative sample of the general population, found the cost to be lower than in studies analyzing samples of patients with previous diagnoses of COPD. The cost distribution is not in line with recommended health care practices, underlining the need to optimize resources used to monitor and treat the disease, with an emphasis on early diagnosis.</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">En los estudios realizados hasta ahora, el coste de la enfermedad pulmonar obstructiva crónica (EPOC) puede estar sobrestimado porque han incluido a pacientes previamente diagnosticados que consultaron por sus síntomas, por lo que la gravedad puede ser superior a la que realmente tendría una población no seleccionada obtenida de la población general. El propósito del presente estudio fue estimar el coste directo de la EPOC basándose en una muestra representativa del conjunto de la población española de entre 40 y 69 años (estudio IBERPOC).</p> <span class="elsevierStyleSectionTitle">Método</span><p class="elsevierStyleSimplePara elsevierViewall">El coste se evaluó retrospectivamente a través de un cuestionario referido al último año en los 363 pacientes con EPOC del estudio IBERPOC. Un neumólogo realizó a todos ellos una espirometría estandarizada en cada una de las 7 áreas geográficas en las que se llevó a cabo el estudio.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">La asistencia hospitalaria fue el coste más elevado (41% del coste total), seguido del tratamiento farma-cológico (37%). El coste por paciente fue de 98,39 €, y por paciente previamente diagnosticado, de 909,5 €. El coste de la EPOC grave por persona fue más de tres veces el coste de la EPOC moderada y más de 7 veces el coste de la EPOC leve. El coste anual estimado de la EPOC en España fue de 238,82 millones de euros (información referida a 1997).</p> <span class="elsevierStyleSectionTitle">Conclusión</span><p class="elsevierStyleSimplePara elsevierViewall">Éste es el primer estudio que estima el coste de la EPOC en una muestra representativa de la población general, que es inferior al calculado por los estudios que han analizado una muestra seleccionada con diagnóstico previo de EPOC. La distribución del gasto no se ajusta a las prácticas asistenciales recomendables, por lo que son necesarias actuaciones que optimicen los recursos empleados en el seguimiento y en el tratamiento de la enfermedad, prestando especial atención a su diagnóstico temprano.</p>" ] ] "NotaPie" => array:1 [ 0 => array:1 [ "nota" => "<p class="elsevierStyleNotepara">The IBERPOC study is an initiative of the Assembly on Respiratory Insufficiency and Sleep Disorders (IRTS) of the Spanish Society of Pneumology and Thoracic Surgery (SEPAR).</p> <p class="elsevierStyleNotepara">Funding was obtained from Boehringer Ingelheim Spain, S. A.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "REFERENCES" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:35 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease: NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) Workshop summary" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "RA Pauwels" 1 => "AS Buist" 2 => "PMA Calverley" 3 => "CR Jenkins" 4 => "SS Hurd" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1164/ajrccm.163.5.2101039" "Revista" => array:6 [ "tituloSerie" => "Am J Respir Crit Care Med" "fecha" => "2001" "volumen" => "163" "paginaInicial" => "1256" "paginaFinal" => "1276" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11316667" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:1 [ "host" => array:2 [ 0 => array:1 [ "Libro" => array:4 [ "titulo" => "Fact sheet: chronic obstructive pulmonary disease (COPD)" "fecha" => "2001" "editorial" => "American Lung Association" "editorialLocalizacion" => "New York" ] ] 1 => array:1 [ "WWW" => array:1 [ "link" => "Available at http://www.lungusa.org/pub/minority/mldd_OO.html" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:1 [ "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:3 [ "titulo" => "Statistical abstract of the United States, 2000" "paginaInicial" => "91" "serieFecha" => "2000" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Ministerio de Sanidad y Consumo" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:4 [ "titulo" => "Plan de Salud 1995. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 3 | 4 | 7 |
| 2024 October | 31 | 20 | 51 |
| 2024 September | 32 | 24 | 56 |
| 2024 August | 45 | 42 | 87 |
| 2024 July | 27 | 22 | 49 |
| 2024 June | 37 | 27 | 64 |
| 2024 May | 39 | 28 | 67 |
| 2024 April | 15 | 21 | 36 |
| 2024 March | 22 | 20 | 42 |
| 2024 February | 20 | 17 | 37 |
| 2023 March | 1 | 2 | 3 |
| 2023 February | 11 | 22 | 33 |
| 2023 January | 14 | 31 | 45 |
| 2022 December | 18 | 25 | 43 |
| 2022 November | 13 | 12 | 25 |
| 2022 October | 18 | 32 | 50 |
| 2022 September | 11 | 19 | 30 |
| 2022 August | 15 | 31 | 46 |
| 2022 July | 20 | 39 | 59 |
| 2022 June | 15 | 34 | 49 |
| 2022 May | 17 | 26 | 43 |
| 2022 April | 15 | 31 | 46 |
| 2022 March | 21 | 36 | 57 |
| 2022 February | 13 | 42 | 55 |
| 2022 January | 15 | 33 | 48 |
| 2021 December | 18 | 38 | 56 |
| 2021 November | 22 | 44 | 66 |
| 2021 October | 63 | 46 | 109 |
| 2021 September | 40 | 55 | 95 |
| 2021 August | 36 | 34 | 70 |
| 2021 July | 20 | 30 | 50 |
| 2021 June | 17 | 32 | 49 |
| 2021 May | 12 | 26 | 38 |
| 2021 April | 40 | 62 | 102 |
| 2021 March | 17 | 17 | 34 |
| 2021 February | 11 | 17 | 28 |
| 2021 January | 9 | 8 | 17 |
| 2020 December | 5 | 13 | 18 |
| 2020 November | 14 | 17 | 31 |
| 2020 October | 6 | 15 | 21 |
| 2020 September | 5 | 7 | 12 |
| 2020 August | 8 | 15 | 23 |
| 2020 July | 9 | 20 | 29 |
| 2020 June | 13 | 6 | 19 |
| 2020 May | 16 | 16 | 32 |
| 2020 April | 14 | 17 | 31 |
| 2020 March | 19 | 17 | 36 |
| 2020 February | 23 | 13 | 36 |
| 2020 January | 11 | 17 | 28 |
| 2019 December | 14 | 14 | 28 |
| 2019 November | 15 | 18 | 33 |
| 2019 October | 11 | 10 | 21 |
| 2019 September | 5 | 13 | 18 |
| 2019 August | 14 | 10 | 24 |
| 2019 July | 10 | 19 | 29 |
| 2019 June | 9 | 8 | 17 |
| 2019 May | 16 | 9 | 25 |
| 2019 April | 15 | 8 | 23 |
| 2019 March | 15 | 14 | 29 |
| 2019 February | 10 | 11 | 21 |
| 2019 January | 7 | 5 | 12 |
| 2018 December | 9 | 11 | 20 |
| 2018 November | 21 | 15 | 36 |
| 2018 October | 27 | 21 | 48 |
| 2018 September | 12 | 12 | 24 |
| 2018 May | 2 | 0 | 2 |
| 2018 April | 16 | 5 | 21 |
| 2018 March | 3 | 3 | 6 |
| 2018 February | 3 | 6 | 9 |
| 2018 January | 3 | 9 | 12 |
| 2017 December | 9 | 8 | 17 |
| 2017 November | 2 | 9 | 11 |
| 2017 October | 5 | 14 | 19 |
| 2017 September | 3 | 14 | 17 |
| 2017 August | 3 | 16 | 19 |
| 2017 July | 5 | 25 | 30 |
| 2017 June | 5 | 29 | 34 |
| 2017 May | 6 | 10 | 16 |
| 2017 April | 3 | 12 | 15 |
| 2017 March | 3 | 11 | 14 |
| 2017 February | 2 | 8 | 10 |
| 2017 January | 4 | 5 | 9 |
| 2016 December | 12 | 10 | 22 |
| 2016 November | 15 | 13 | 28 |
| 2016 October | 16 | 15 | 31 |
| 2016 September | 17 | 12 | 29 |
| 2016 August | 14 | 7 | 21 |
| 2016 July | 8 | 4 | 12 |
| 2016 March | 2 | 0 | 2 |
| 2015 December | 2 | 0 | 2 |
| 2015 October | 40 | 1 | 41 |
| 2015 September | 36 | 5 | 41 |
| 2015 August | 30 | 8 | 38 |
| 2015 July | 38 | 9 | 47 |
| 2015 June | 38 | 4 | 42 |
| 2015 May | 40 | 6 | 46 |
| 2015 April | 29 | 7 | 36 |
| 2015 March | 36 | 7 | 43 |
| 2015 February | 25 | 2 | 27 |
| 2015 January | 23 | 6 | 29 |
| 2014 December | 39 | 11 | 50 |
| 2014 November | 38 | 5 | 43 |
| 2014 October | 45 | 11 | 56 |
| 2014 September | 33 | 8 | 41 |
| 2014 August | 42 | 11 | 53 |
| 2014 July | 43 | 9 | 52 |
| 2014 June | 50 | 8 | 58 |
| 2014 May | 52 | 10 | 62 |
| 2014 April | 50 | 9 | 59 |
| 2014 March | 73 | 7 | 80 |
| 2014 February | 57 | 9 | 66 |
| 2014 January | 31 | 6 | 37 |
| 2013 December | 36 | 11 | 47 |
| 2013 November | 27 | 4 | 31 |
| 2013 October | 26 | 11 | 37 |
| 2013 September | 26 | 14 | 40 |
| 2013 August | 31 | 10 | 41 |
| 2013 July | 43 | 14 | 57 |
| 2013 June | 28 | 8 | 36 |
| 2013 May | 26 | 6 | 32 |
| 2013 April | 22 | 3 | 25 |
| 2013 March | 9 | 2 | 11 |
Show all
