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Diffuse Lung Disease |

Retrospective Cohort Study to Assess Patterns of Healthcare Resource Use in US Patients With Idiopathic Pulmonary Fibrosis Versus Matched Controls

Ning Wu, PhD; Yanni Yu, MA; Chien-Chia Chuang, PhD; Rosa Wang, MHA; Nicole Benjamin, BS; David Coultas, MD
Author and Funding Information

United BioSource Corporation, Lexington, MA


Chest. 2013;144(4_MeetingAbstracts):472A. doi:10.1378/chest.1702756
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Abstract

SESSION TITLE: Interstitial Lung Disease

SESSION TYPE: Original Investigation Slide

PRESENTED ON: Wednesday, October 30, 2013 at 02:45 PM - 04:15 PM

PURPOSE: Few studies have characterized the burden of illness among patients with idiopathic pulmonary fibrosis (IPF). This study compared comorbidity profiles and healthcare resource utilization (HRU) between commercially-insured patients with and without IPF.

METHODS: A national administrative claims database (2006-2011) was analyzed. Newly-diagnosed IPF patients were identified as those having ≥2 claims with pulmonary fibrosis or idiopathic fibrosing alveolitis as the primary diagnosis (IPF diagnosis), a procedure of lung biopsy or high resolution computed tomography of thorax within ±90 days of receiving the earliest IPF diagnosis (index date), and ≥2 confirmatory diagnoses after the procedure. For each IPF patient, 3 non-IPF control patients were matched by age (±2 years), gender, region of residence, and payer type. Baseline comorbidities and HRU during one year post-index were compared. A conditional logistic model adjusting for demographics and comorbidities was constructed to estimate risk for post-index hospitalization.

RESULTS: 1,505 IPF patients and 4,515 controls (mean age: 71 years; 53.9% male) were included. Chronic comorbidities were more prevalent in IPF patients than in controls: hypertension (58.5% vs. 29.5%), chronic obstructive pulmonary disorder (36.7% vs. 4.4%), diabetes (26.5% vs. 12.4%), arrhythmia (24.2% vs. 7.6%), congestive heart failure (22.7% vs. 3.7%), gastroesophageal reflux (22.1% vs. 6.3%), and depression (9.1% vs. 3.6%); with all p<0.01. The average Charlson Comorbidity score was also higher (1.71 vs. 0.47, p<0.01). During the post-index period, IPF patients were more likely to have ≥1 hospitalization (33.7% vs. 13.7%) or ER visit (37.3% vs. 20.6%), had a longer inpatient stay (mean: 4.4 vs. 1.9 days), and more physician office visits (mean: 16.6 vs. 7.7) than controls (all p<0.01). Multivariate analysis confirmed that IPF patients were more likely to be hospitalized compared to controls after adjusting for covariates (Odds Ratio=1.78, 95% confidence interval: 1.47-2.15).

CONCLUSIONS: Burden of illness from co-morbid conditions and healthcare resource utilization is considerably higher among patients with IPF compared to matched controls.

CLINICAL IMPLICATIONS: Effective IPF treatments and comorbidity management may decrease high healthcare utilization.

DISCLOSURE: Ning Wu: Employee: Ning Wu is an employee of United BioSource Corporation (UBC), which provides consulting and other research services to pharmaceutical, device, government, and non-government organizations. In her salaried position, she works with a variety of companies and organizations, and is precluded from receiving payment or honoraria directly from these organizations for services rendered during the preparation of this manuscript. Yanni Yu: Employee: Yanni Yu is an employee of Boehringer Ingelheim which provided funding for this study. Chien-Chia Chuang: Employee: Chien-Chia Chuang is an employee of United BioSource Corporation (UBC), which provides consulting and other research services to pharmaceutical, device, government, and non-government organizations. In her salaried position, she works with a variety of companies and organizations, and is precluded from receiving payment or honoraria directly from these organizations for services rendered during the preparation of this manuscript. Rosa Wang: Employee: Rosa Wang is an employee of United BioSource Corporation (UBC), which provides consulting and other research services to pharmaceutical, device, government, and non-government organizations. In her salaried position, she works with a variety of companies and organizations, and is precluded from receiving payment or honoraria directly from these organizations for services rendered during the preparation of this manuscript. Nicole Benjamin: Employee: Nicole Benjamin is an employee of United BioSource Corporation (UBC), which provides consulting and other research services to pharmaceutical, device, government, and non-government organizations. In her salaried position, she works with a variety of companies and organizations, and is precluded from receiving payment or honoraria directly from these organizations for services rendered during the preparation of this manuscript. David Coultas: Consultant fee, speaker bureau, advisory committee, etc.: David Coultas is employed by University of Texas Health Science Center at Tyler and is a physician consultant paid by Boehringer Ingelheim.

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