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Med. Sci. 2017, 5(4), 20; doi:10.3390/medsci5040020

Healthcare Cost and Utilization before and after Diagnosis of Pseudomonas aeruginosa among Patients with Non-Cystic Fibrosis Bronchiectasis in the U.S.

1
University of North Carolina at Charlotte, Department of Public Health Sciences, Charlotte, NC 28223, USA
2
Precision Health Economics, Huntersville, NC 28078, USA
3
Grifols, Durham, NC 27709, USA
4
University of New Mexico College of Pharmacy, Albuquerque, NM 87131, USA
*
Author to whom correspondence should be addressed.
Received: 15 August 2017 / Revised: 15 September 2017 / Accepted: 19 September 2017 / Published: 23 September 2017
(This article belongs to the Special Issue Selected Papers from the 1st World Bronchiectasis Conference)
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Abstract

Non-cystic fibrosis bronchiectasis (NCFBE) is a rare, chronic lung disease characterized by bronchial inflammation and permanent airway dilation. Chronic infections with P. aeruginosa have been linked to higher morbidity and mortality. To understand the impact of P. aeruginosa in NCFBE on health care costs and burden, we assessed healthcare costs and utilization before and after P. aeruginosa diagnosis. Using data from 2007 to 2013 PharMetrics Plus administrative claims, we included patients with ≥2 claims for bronchiectasis and >1 claim for P. aeruginosa; then excluded those with a claim for cystic fibrosis. Patients were indexed at first claim for P. aeruginosa and were required to have >12 months before and after the index P. aeruginosa. The mean differences in utilization and costs were assessed using paired Student’s t-tests for statistical significance. Mean total healthcare costs per patient were $36,213 pre-P. aeruginosa diagnosis versus $67,764 post-P. aeruginosa, an increase of 87% (p < 0.0001). Inpatient costs represented the largest proportion of total healthcare costs post-P. aeruginosa (54%) with an increase of four hospitalizations per patient (p < 0.0001). NCFBE patients with evidence of P. aeruginosa incur substantially greater healthcare costs and utilization after P. aeruginosa diagnosis. Future research should explore methods of earlier identification of NCFBE patients with P. aeruginosa, as this may lead to fewer severe exacerbations, thereby resulting in a reduction in hospitalizations and healthcare costs. View Full-Text
Keywords: bronchiectasis; Pseudomonas aeruginosa; healthcare costs; healthcare utilization; exacerbations; chronic lung disease; bronchial inflammation bronchiectasis; Pseudomonas aeruginosa; healthcare costs; healthcare utilization; exacerbations; chronic lung disease; bronchial inflammation
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Blanchette, C.M.; Noone, J.M.; Stone, G.; Zacherle, E.; Patel, R.P.; Howden, R.; Mapel, D. Healthcare Cost and Utilization before and after Diagnosis of Pseudomonas aeruginosa among Patients with Non-Cystic Fibrosis Bronchiectasis in the U.S.. Med. Sci. 2017, 5, 20.

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