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Understanding resource utilization and mortality in COPD to support policy making: A microsimulation study

Chronic obstructive pulmonary disease (COPD) poses a significant but heterogeneous burden to individuals and healthcare systems. Policymakers develop targeted policies to minimize this burden but need personalized tools to evaluate novel interventions and target them to subpopulations most likely to...

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Autores principales: Bond, Elizabeth G., Abrahamyan, Lusine, Khan, Mohammad K. A., Gershon, Andrea, Krahn, Murray, Li, Ping, Mian, Rajibul, Mitsakakis, Nicholas, Sadatsafavi, Mohsen, To, Teresa, Pechlivanoglou, Petros
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7444558/
https://www.ncbi.nlm.nih.gov/pubmed/32817636
http://dx.doi.org/10.1371/journal.pone.0236559
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author Bond, Elizabeth G.
Abrahamyan, Lusine
Khan, Mohammad K. A.
Gershon, Andrea
Krahn, Murray
Li, Ping
Mian, Rajibul
Mitsakakis, Nicholas
Sadatsafavi, Mohsen
To, Teresa
Pechlivanoglou, Petros
author_facet Bond, Elizabeth G.
Abrahamyan, Lusine
Khan, Mohammad K. A.
Gershon, Andrea
Krahn, Murray
Li, Ping
Mian, Rajibul
Mitsakakis, Nicholas
Sadatsafavi, Mohsen
To, Teresa
Pechlivanoglou, Petros
author_sort Bond, Elizabeth G.
collection PubMed
description Chronic obstructive pulmonary disease (COPD) poses a significant but heterogeneous burden to individuals and healthcare systems. Policymakers develop targeted policies to minimize this burden but need personalized tools to evaluate novel interventions and target them to subpopulations most likely to benefit. We developed a platform to identify subgroups that are at increased risk of emergency department visits, hospitalizations and mortality and to provide stratified patient input in economic evaluations of COPD interventions. We relied on administrative and survey data from Ontario, Canada and applied a combination of microsimulation and multi-state modeling methods. We illustrated the functionality of the platform by quantifying outcomes across smoking status (current, former, never smokers) and by estimating the effect of smoking cessation on resource use and survival, by comparing outcomes of hypothetical cohorts of smokers who quit at diagnosis and smokers that continued to smoke post diagnosis. The cumulative incidence of all-cause mortality was 37.9% (95% CI: 34.9, 41.4) for never smokers, 34.7% (95% CI: 32.1, 36.9) for current smokers, and 46.4% (95% CI: 43.6, 49.0) for former smokers, at 14 years. Over 14 years, smokers who did not quit at diagnosis had 16.3% (95% CI: 9.6, 38.4%) more COPD-related emergency department visits than smokers who quit at diagnosis. In summary, we combined methods from clinical and economic modeling to create a novel tool that policymakers and health economists can use to inform future COPD policy decisions and quantify the effect of modifying COPD risk factors on resource utilization and morality.
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spelling pubmed-74445582020-08-27 Understanding resource utilization and mortality in COPD to support policy making: A microsimulation study Bond, Elizabeth G. Abrahamyan, Lusine Khan, Mohammad K. A. Gershon, Andrea Krahn, Murray Li, Ping Mian, Rajibul Mitsakakis, Nicholas Sadatsafavi, Mohsen To, Teresa Pechlivanoglou, Petros PLoS One Research Article Chronic obstructive pulmonary disease (COPD) poses a significant but heterogeneous burden to individuals and healthcare systems. Policymakers develop targeted policies to minimize this burden but need personalized tools to evaluate novel interventions and target them to subpopulations most likely to benefit. We developed a platform to identify subgroups that are at increased risk of emergency department visits, hospitalizations and mortality and to provide stratified patient input in economic evaluations of COPD interventions. We relied on administrative and survey data from Ontario, Canada and applied a combination of microsimulation and multi-state modeling methods. We illustrated the functionality of the platform by quantifying outcomes across smoking status (current, former, never smokers) and by estimating the effect of smoking cessation on resource use and survival, by comparing outcomes of hypothetical cohorts of smokers who quit at diagnosis and smokers that continued to smoke post diagnosis. The cumulative incidence of all-cause mortality was 37.9% (95% CI: 34.9, 41.4) for never smokers, 34.7% (95% CI: 32.1, 36.9) for current smokers, and 46.4% (95% CI: 43.6, 49.0) for former smokers, at 14 years. Over 14 years, smokers who did not quit at diagnosis had 16.3% (95% CI: 9.6, 38.4%) more COPD-related emergency department visits than smokers who quit at diagnosis. In summary, we combined methods from clinical and economic modeling to create a novel tool that policymakers and health economists can use to inform future COPD policy decisions and quantify the effect of modifying COPD risk factors on resource utilization and morality. Public Library of Science 2020-08-20 /pmc/articles/PMC7444558/ /pubmed/32817636 http://dx.doi.org/10.1371/journal.pone.0236559 Text en © 2020 Bond et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Bond, Elizabeth G.
Abrahamyan, Lusine
Khan, Mohammad K. A.
Gershon, Andrea
Krahn, Murray
Li, Ping
Mian, Rajibul
Mitsakakis, Nicholas
Sadatsafavi, Mohsen
To, Teresa
Pechlivanoglou, Petros
Understanding resource utilization and mortality in COPD to support policy making: A microsimulation study
title Understanding resource utilization and mortality in COPD to support policy making: A microsimulation study
title_full Understanding resource utilization and mortality in COPD to support policy making: A microsimulation study
title_fullStr Understanding resource utilization and mortality in COPD to support policy making: A microsimulation study
title_full_unstemmed Understanding resource utilization and mortality in COPD to support policy making: A microsimulation study
title_short Understanding resource utilization and mortality in COPD to support policy making: A microsimulation study
title_sort understanding resource utilization and mortality in copd to support policy making: a microsimulation study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7444558/
https://www.ncbi.nlm.nih.gov/pubmed/32817636
http://dx.doi.org/10.1371/journal.pone.0236559
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