[Pharmacotherapy and costs of DRD 88. Chronic obstructive pulmonary disease in hospital]

Diagnosis-Related Group (DRG) 88 -chronic obstructive pulmonary disease is one of the most frequent groups of patients in hospital case-mix and accounts for substantial health-care costs. Our purpose was to determine drug utilization pattern and related costs for this DRG and to analyse their relationship with several factors.

288 patients treated at a tertiary referral hospital between january and december 1997 were studied. We analysed demographic, clinical, and administrative data, as well as drugs prescription and cost for every patient.

Most patients received antibiotics (n=267) which, in addition, represented 46% of total pharmacy cost of this DRG. Cephalosporines were the most frequently prescribed. 67% of patients were treated with inhaled B-agonists and theophillyne, whereas the combination of B-agonists and Ipratropium Bromide was less frequent (n=152). Oral or parenteral corticosteroids were used in 233 patients. This treatment regime presented differences according to main diagnosis and to department responsible for patient discharge. Cost per episode was 116,6 +/- 110,5 euros. Cost per hospital stay was 13,1+/- 15,5 euros. Correlation of pharmacy costs with length of stay was moderate.

Pharmacy costs are mainly determined by the use of antibiotics. Treatment pattern shows a certain variability that can be attributed to patients clinical features as well as to physician prescribing habits.