PURPOSE: The annual cost of chronic obstructive pulmonary disease (COPD) in the US is >$32 billion. Anemia is an independent contributor to the healthcare costs in some populations with COPD, with hospitalizations being the greatest driver of these costs(1). The aim of this study was to evaluate the association of anemia diagnosis with healthcare resource utilization (i.e., length of stay and charges) in hospitalized patients with COPD.
METHODS: Hospital discharges with COPD were identified from the 2003 Agency for Healthcare Research and Quality Hospital Cost and Utilization Project/National Inpatient Sample based on ICD-9-CM discharge diagnosis codes . Anemia discharges (A+) were identified through anemia diagnosis codes or indications of transfusion(s) in the absence of major GI bleeding, trauma, or surgery. Discharges with a dialysis code or diagnoses of end stage renal disease, malignancy, or HIV were excluded.
RESULTS: Of the 3,271,677 discharges identified with COPD, 552,782 (17%) met the criteria for anemia. A+ discharges were more likely to be for older, female and non-Caucasian patients with higher acute and chronic disease burden (p<0.0001) than non-anemic (A-) discharges. Mean hospital length of stay was longer for A+ than A- discharges (7.4 + 0.08 A+ vs. 5.8 + 0.04 A- days, p<0.0001). Mean total hospital charges were also significantly higher for A+ than A- discharges ($31,453 + $840 A+ vs. $24, 298 + $599 A-, p<0.0001).
CONCLUSION: Anemia is associated with longer hospital lengths of stay and higher total hospital charges. Because patients with anemia are likely to have a higher disease burden, further work is necessary to understand whether anemia contributes independently to this increase in the observed intensity of hospital resource utilization.
CLINICAL IMPLICATIONS: Anemia in hospitalized COPD patients may be a marker of more severe illness and increased resource utilization.(1)Halpern MT et al. Chest 2005;128:257S.
DISCLOSURE: Marya Zilberberg, Grant monies (from industry related sources) Ortho Biotech Clinical Affairs, LLC; Shareholder Johnson & Johnson; Employee Johnson & Johnson.