Anemia, costs and mortality in chronic obstructive pulmonary disease

Michael Halpern, Marya D. Zilberberg, Jordana K. Schmier, Edmund C. Lau, Andrew F. Shorr

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Background: Little is known about cost implications of anemia and its association with mortality in chronic obstructive pulmonary disease (COPD). This claims analysis addresses these questions. Methods: Using the the US Medicare claims database (1997-2001), this study identified Medicare enrollees with an ICD-9 diagnosis of COPD. Concomitant anemia was identified based on ICD-9 codes or receipt of transfusions. Persons with anemia secondary to another disease state, a nutritional deficiency or a hereditary disease were excluded. Medicare claims and payments, resource utilization and mortality were compared between COPD patients with and without anemia. Results: Of the 132,424 enrollees with a COPD diagnosis, 21% (n = 27,932) had concomitant anemia. At baseline, anemic patients were older, had more co-morbidities and higher rates of health care resource use than non-anemic individuals with COPD. In a univariate analysis annual Medicare payments for persons with anemia were more than double for those without anemia ($1,466 vs. $649, p < 0.001), the direction maintained in all categories of payments. Adjusting for demographics, co-morbidities, and other markers of disease severity revealed that anemia was independently associated with $3,582 incremental increase per patient (95% CI: $3,299 to $3,865) in Medicare annual reimbursements. The mortality rate among COPD patients with anemia was 262 vs. 133 deaths per 1,000 person-years among those without anemia (p < 0.001). Conclusion: Anemia was present in 21% of COPD patients. Although more prevalent in more severely ill COPD patients, anemia significantly and independently contributes to the costs of care for COPD and is associated with increased mortality.

Original languageEnglish (US)
Article number17
JournalCost Effectiveness and Resource Allocation
Volume4
DOIs
StatePublished - Oct 16 2006
Externally publishedYes

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Chronic Obstructive Pulmonary Disease
Anemia
Costs and Cost Analysis
Mortality
Medicare
International Classification of Diseases
Insurance Claim Review
Morbidity
Inborn Genetic Diseases
Health Resources
Malnutrition
Demography
Databases
Delivery of Health Care

ASJC Scopus subject areas

  • Health Policy

Cite this

Anemia, costs and mortality in chronic obstructive pulmonary disease. / Halpern, Michael; Zilberberg, Marya D.; Schmier, Jordana K.; Lau, Edmund C.; Shorr, Andrew F.

In: Cost Effectiveness and Resource Allocation, Vol. 4, 17, 16.10.2006.

Research output: Contribution to journalArticle

Halpern, Michael ; Zilberberg, Marya D. ; Schmier, Jordana K. ; Lau, Edmund C. ; Shorr, Andrew F. / Anemia, costs and mortality in chronic obstructive pulmonary disease. In: Cost Effectiveness and Resource Allocation. 2006 ; Vol. 4.
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