[Inpatient treatment costs of exacerbated chronic obstructive lung disease]

Economic aspects are of increasing importance in health care. However, treatment expenditures for most diseases are unknown. We performed a detailed cost analysis for the treatment of the exacerbated chronic obstructive pulmonary disease (ECOPD) in our department. For one year, all patients admitted because of exacerbated chronic obstructive pulmonary disease were included in this study. The workload was assessed for each patient by time keeping. Diagnostic and therapeutic procedures were considered according to the price list of the German hospital association. From 101 patients included into the study, 100 were evaluable. The median duration of inpatient hospitalisation amounted to 18 days (range: 4 to 210 days). Median total cost was DM 7680.- and mean cost DM 11900.-. This consisted of non-medical cost items (36%), personnel expenditures (29%), laboratory tests (14%), respiratory and cardiovascular laboratory (7%), radiology (5%) and pharmacy cost (7%). Endoscopy, external diagnostics and medical reports amounted to 2.8% of the expenditure. Treatment cost correlated with the duration of stay, but hardly with lung function and blood gases, these being independent of age and sex, but significantly higher in case of bronchiectasis, enterobacteriae, cor pulmonale or intensive care. The proportion of the pharmacy expenditures was rather small, and hence this is not a primary target for the realisation of major savings.