Abstract

Background and Aim

Early appropriate treatment of interstitial lung diseases (ILD) is crucial to slow down disease progression and to improve survival. Our study assessed mortality, all-cause and respiratory-related hospitalizations, and health care costs of ILD-patients initially treated in specialised ILD-centres (sIc) vs. non-specialised centres (nsIc) and explored differences in treatment patterns.

Methods

We analysed claims data of patients diagnosed with different forms of ILD in Germany between 2013 and 2018. Classification of centres as (n)sIc was based on number of patients treated and procedures, defined by the European Network on Rare Lung Diseases. Stabilized inverse probability of treatment weighting was used to adjust for covariates. Mortality and hospitalization were examined via weighted Cox models, cost differences by weighted gamma regression models, and potential differences in treatment pattern with weighted logistic regression.

Results

We compared 2022 patients treated in seven sIc with 28771 patients treated in 1156 nsIc. SIc-treatment was associated with lower mortality (HR: 0.87, 95%CI: 0.78; 0.96), lower all-cause hospitalization (HR: 0.93, 95%CI: 0.87; 0.98), and higher respiratory-related costs (€669, 95%CI: €219; €1156). While treatment patterns also differed, risk of respiratory-related hospitalizations (HR: 1.00, 95%CI: 0.92, 1.10) and overall costs (€-872, 95%CI: €-75; €1817) did not.

Conclusion

Initial treatment in sIc is associated with positive effects on mortality and all-cause hospitalization, which might be due to different diagnostic and treatment management. Improved cooperation between sIc and nsIc might be beneficial for ILD-patients.