Economic and health consequences of COPD patients and their spouses in Denmark--1998-2010

Abstract

Objective: Chronic Obstructive Pulmonary Disease (COPD) is among the leading causes of morbidity and mortality worldwide, but longitudinal studies of the economic consequences of COPD are scarce. This study evaluated the economic consequences of COPD patients in Denmark and their spouses at a national level before and after initial diagnosis.

Methods: Using records from the Danish National Patient Registry (1998-2010), 171,557 patients with COPD and 86,260 spouses were identified; patients were compared with 664,821, and the spouses with 346,524, all controls were randomly selected and matched for age, gender and residence. Direct and indirect costs, including frequency of primary and secondary sector contacts and procedures, medication, unemployment benefits and social transfer payments were extracted from national databases for patients, spouses and controls.

Results: COPD patients are earning approximately half of that of controls before diagnosis. After diagnosis this effect diminishes due to people getting older and retiring from work (65 years). Total health expenses are more than twice as high in the COPD group regardless of age and gender compared to controls. Spouses of COPD patients had significantly higher rates of health-related contacts, medication use and higher socioeconomic costs compared to controls. The employment and income rates of employed spouses of COPD patients were significantly lower compared to controls.

Conclusion: This study provides unique data on the economic consequences of COPD patients in Denmark and their spouses as well as displaying the serious health consequences for the individual spouse and society. Second, data shows substantial impact of COPD on income level and health expenses regardless of age and gender. It could be speculated that early identification and intervention might contribute to more health and economic equality between patients and controls.

Keywords: Chronic obstructive pulmonary disease; economic burden; employment; health costs; illness costs.