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"Our research is unique in its attempt to describe a high-need, high-cost patient population who might benefit from increased monitoring or intervention," Dr. Ann Cameron says.
Ann Cameron, the associate director for Health Economics & Outcomes Research from ResMed shared new data which showed patients with high-risk COPD had an increased burden of comorbid conditions and relied more on COPD medications and oxygen.1
Cameron and her team of investigators aimed to identify characteristics associated with poor clinical outcomes in these patients. Patients were considered high-risk if they were 55 years or older with prior exacerbations, Medicaid or dual Medicaid/Medicare Advantage insurance, and moderate or high COPD complexity.
Results also indicated this population exhibited increased healthcare utilization, including emergency department visits and hospitalizations for both all causes and COPD-related issues. When compared with non-high-risk patients, they incurred significantly higher healthcare costs, with COPD-related hospitalization costs being over 6 times higher than those of non-high-risk patients.
Cameron shared more insight on the investigation with HCPLive.2
HCPLive: Can you elaborate on the factors contributing to the significantly higher healthcare costs and resource utilization observed among high-risk COPD patients compared to non-high-risk patients?
Cameron: For this initial analysis, we examined unadjusted group differences between patients we defined as high-risk versus patients who did not meet those criteria. We can hypothesize that factors such as higher comorbidity burden, longer stays in the hospital, and more than 30-day hospital readmissions in the high-risk patient group contributed to these differences, and we plan to explore predictive factors in a future analysis.
Were there any unexpected or surprising findings in your research? How do these findings contribute to the existing knowledge on COPD exacerbations and healthcare outcomes?
Although we expected to see higher COPD-related healthcare resource use and costs among high-risk patients, we were somewhat surprised by the magnitude of the group differences in all-cause hospitalizations, emergency department visits, and associated costs. However, these findings make sense with the high comorbidity burden of patients with COPD, especially among patients we defined as high-risk in the study.
It is well-established that COPD-related exacerbations lead to higher healthcare costs and poorer health outcomes and predictors of exacerbations have been explored previously in patients with COPD. Our research is unique in its attempt to describe a high-need, high-cost patient population who might benefit from increased monitoring or intervention.
In your opinion, what are the key areas that need further research or exploration regarding COPD exacerbations and their impact on patient outcomes and healthcare resource utilization?
Insurance claims data, which we used in our study, have some inherent limitations such as lack of clinical parameters (e.g., pulmonary function test results) and other variables known to affect exacerbation risk. Future analyses could be refined with datasets that include variables such as clinical parameters, smoking status, behavioral factors, and social determinants of health variables such as race and socioeconomic status to allow for more precise identification of high-risk patients.
Being able to predict and prevent exacerbations would greatly benefit patients and reduce healthcare resource use and costs. This is a critical area of research in general and for ResMed in particular. For example, colleagues at ResMed are working on a COPD exacerbation prediction model using Propeller Health user data combined with insurance claims data to allow for early detection of exacerbations and an opportunity for earlier intervention by healthcare providers.