Source: Annual Congress 2002 - Chronic care and rehabilitation in the management of acute exacerbations
Disease area: Airway diseases

Abstract

The factors determining health care utilization in COPD patients remain poorly identified. We studied health care utilization and its relation to functional variables in COPD patients. One hundred ninety-five patients (age 62±]11years) with severe COPD (FEV1 39±]13% predicted, TL,co 43±]16% predicted) were evaluated. Pulmonary function, quadriceps force (QF), handgrip force (HF), respiratory muscle force (PEmax and PImax), 6-minute walking distance (6-MWD), maximal exercise capacity (VO2peak) and fat free mass (FFM) were studied. The number (n) of visits to a general practitioner (7.99±]7.88), n hospital admissions (1.01±]0.99), n hospital days (11.67±]15.94) and the average daily dose of methylprednisolone eq. (5.50±]5.55mg) were retrospectively collected over the last 6 months. All variables of health care utilization correlated inversely with 6-MWD (r ranging from -0.29 to -0.37, p=0.0001). The number of admissions and hospital days correlated inversely with QF, HF, PEmax and VO2peak (r ranging from -0.15 to -0.24, p ranging from 0.034 to 0.0008). Also FFM correlated inversely with n hospital admissions and n hospital days (r=-0.21 and -0.29, p=0.007 and 0.0001). In a stepwise multiple regression analysis, variables significantly related to n hospital days were 6-MWD (p=0.0001), FFM (p=0.006) an QF (p=0.035). The total variance explained by this model was 18%. Pulmonary function did not further contribute to this model. We conclude that peripheral muscle force, maximal exercise capacity and FFM were significant determinants of utilization of health care resources. Functional variables only explained a fraction of the variance in health care utilization.
Supported by [dsquote]FWO-Vlaanderen[dsquote] grant # G.0237.01 and [dsquote]Levenslijn[dsquote] grant # 7.0007.00.

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P. Bogaerts, L. Herremans, T. Troosters, M. A. Spruit, G. Celis, B. Salhi, R. Gosselink, E. Derom, M. Decramer (Leuven, Gent, Belgium). Utilization of health care resources in patients with COPD. Eur Respir J 2002; 20: Suppl. 38, 3707

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