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How different combinations of comorbidities affect healthcare use by elderly patients with obstructive lung disease

Previous research had shown the number of comorbidities is a major factor influencing the burden of care for elderly patients with obstructive lung disease (OLD). This retrospective cohort study on a large population of elderly patients (age > 65 years) with OLD in northern Italy measures the use...

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Autores principales: Buja, Alessandra, Bardin, Andrea, Grotto, Giulia, Elvini, Stefania, Gallina, Pietro, Zumerle, Giulia, Benini, Patrizia, Scibetta, Domenico, Baldo, Vincenzo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8149628/
https://www.ncbi.nlm.nih.gov/pubmed/34035314
http://dx.doi.org/10.1038/s41533-021-00242-y
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author Buja, Alessandra
Bardin, Andrea
Grotto, Giulia
Elvini, Stefania
Gallina, Pietro
Zumerle, Giulia
Benini, Patrizia
Scibetta, Domenico
Baldo, Vincenzo
author_facet Buja, Alessandra
Bardin, Andrea
Grotto, Giulia
Elvini, Stefania
Gallina, Pietro
Zumerle, Giulia
Benini, Patrizia
Scibetta, Domenico
Baldo, Vincenzo
author_sort Buja, Alessandra
collection PubMed
description Previous research had shown the number of comorbidities is a major factor influencing the burden of care for elderly patients with obstructive lung disease (OLD). This retrospective cohort study on a large population of elderly patients (age > 65 years) with OLD in northern Italy measures the use of healthcare resources associated with the most frequent combinations of comorbidities and investigates the most common reasons for hospitalization. Total health costs, pharmacy costs, emergency department (ED) visits, outpatient visits, and hospital admissions are assessed for every subject. The most common causes of hospitalization by a number of comorbidities and the most common sets of three comorbidities are identified. For each comorbidity group, we rank a list of the most frequent causes of hospitalization, both overall and avoidable with effective ambulatory care. A small group of patients suffering from major comorbidities accounts for the use of most healthcare resources. The most frequent causes of hospitalization are respiratory failure, heart failure, chronic bronchitis, and bronchopneumonia. The most common conditions manageable with ambulatory care among causes of hospitalizations are heart failure, bacterial pneumonia, and COPD. The set of three comorbidities responsible for the highest average total costs, and the highest average number of hospitalizations and outpatient visits comprised hypertension, cardiac arrhythmias, and heart failure. The main reasons for hospitalization proved to remain linked to heart failure and acute respiratory disease, regardless of specific combinations of comorbidities. Based on these findings, specific public health interventions among patients with OLD cannot be advised on the basis of specific sets of comorbidities only.
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spelling pubmed-81496282021-06-01 How different combinations of comorbidities affect healthcare use by elderly patients with obstructive lung disease Buja, Alessandra Bardin, Andrea Grotto, Giulia Elvini, Stefania Gallina, Pietro Zumerle, Giulia Benini, Patrizia Scibetta, Domenico Baldo, Vincenzo NPJ Prim Care Respir Med Article Previous research had shown the number of comorbidities is a major factor influencing the burden of care for elderly patients with obstructive lung disease (OLD). This retrospective cohort study on a large population of elderly patients (age > 65 years) with OLD in northern Italy measures the use of healthcare resources associated with the most frequent combinations of comorbidities and investigates the most common reasons for hospitalization. Total health costs, pharmacy costs, emergency department (ED) visits, outpatient visits, and hospital admissions are assessed for every subject. The most common causes of hospitalization by a number of comorbidities and the most common sets of three comorbidities are identified. For each comorbidity group, we rank a list of the most frequent causes of hospitalization, both overall and avoidable with effective ambulatory care. A small group of patients suffering from major comorbidities accounts for the use of most healthcare resources. The most frequent causes of hospitalization are respiratory failure, heart failure, chronic bronchitis, and bronchopneumonia. The most common conditions manageable with ambulatory care among causes of hospitalizations are heart failure, bacterial pneumonia, and COPD. The set of three comorbidities responsible for the highest average total costs, and the highest average number of hospitalizations and outpatient visits comprised hypertension, cardiac arrhythmias, and heart failure. The main reasons for hospitalization proved to remain linked to heart failure and acute respiratory disease, regardless of specific combinations of comorbidities. Based on these findings, specific public health interventions among patients with OLD cannot be advised on the basis of specific sets of comorbidities only. Nature Publishing Group UK 2021-05-25 /pmc/articles/PMC8149628/ /pubmed/34035314 http://dx.doi.org/10.1038/s41533-021-00242-y Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Buja, Alessandra
Bardin, Andrea
Grotto, Giulia
Elvini, Stefania
Gallina, Pietro
Zumerle, Giulia
Benini, Patrizia
Scibetta, Domenico
Baldo, Vincenzo
How different combinations of comorbidities affect healthcare use by elderly patients with obstructive lung disease
title How different combinations of comorbidities affect healthcare use by elderly patients with obstructive lung disease
title_full How different combinations of comorbidities affect healthcare use by elderly patients with obstructive lung disease
title_fullStr How different combinations of comorbidities affect healthcare use by elderly patients with obstructive lung disease
title_full_unstemmed How different combinations of comorbidities affect healthcare use by elderly patients with obstructive lung disease
title_short How different combinations of comorbidities affect healthcare use by elderly patients with obstructive lung disease
title_sort how different combinations of comorbidities affect healthcare use by elderly patients with obstructive lung disease
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8149628/
https://www.ncbi.nlm.nih.gov/pubmed/34035314
http://dx.doi.org/10.1038/s41533-021-00242-y
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