الفهرس 
Chronic Obstructive Pulmonary DiseaseOnly 14 pages are availabe for public view
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Abstract
Summary and Conclusion
Chronic obstructive pulmonary disease (COPD) is a
highly prevalent and debilitating disease that has a significant
impact on patient quality of life and the costs borne by the
health care system. An exacerbation of COPD is the most
common condition that requires hospital admission, and
contributes substantially to the related economic impact.
Therefore, COPD exacerbations have been considered the most
important target for reducing costs.
A study in the UK National Health Service (NHS) in
2001 showed that the total excess primary care cost associated
with acute exacerbations of chronic bronchitis in the COPDdiagnosed
population was £35.7 million.
This included the excess cost of all prescription
medications, general practitioner (GP).
(Nurmatov et al., 2012)
The aim of this study was to compare the Cost of COPD
exacerbations managed in Hospital as regard (Hospital stay,
Antibiotic, Chest Medication, Medications of Co-morbid
diseases) with COPD managed in Outpatient Clinic.
Summary and Conclusion
101
The present study was conducted on (74) male patients
divided to 3 groups:
Group A: consist of COPD patients with acute exacerbation
managed in Chest department.
Group B: consist of COPD patients with acute exacerbation
managed in Respiratory ICU and received mechanical
ventilation.
Group C: consist of COPD patients with acute exacerbation
managed in Respiratory ICU without mechanical ventilation.
All patients were followed after discharge as regard The
Cost of their medications.
The results obtained were collected, tabulated and
submitted for statistical analysis.
from the present study the following results were obtained:
1. There is significant statistical difference between total
cost of medications of COPD patients without co morbid
diseases, and total cost of medications of COPD patients
with Co morbid diseases.
2. There is highly significant statistical difference as regard
Total Cost of medications of COPD patients treated in
Summary and Conclusion
102
chest department versus patients treated Respiratory ICU
(either mechanically ventilated or not).
3. The Cost of Antibiotic increased proportionately with the
increase of severity of COPD patient, as the main cost of
patients treated in chest department was L.E 1259.7± SD
E.L 1256.2) and the main cost of patients treated in
Respiratory ICU (mechanically ventilated) was L.E
4970.7 ± SD L.E 3807.4, the main cost of patients treated
in respiratory ICU (not mechanically ventilated ) was L.E
2627.8 ±1777.3.
4. There is highly significant statistical difference between
studied groups as regard duration of Hospitalization and
frequency of Hospitalization with mean duration of
Hospitalization in chest department was 12.2±5.6 days
and its frequency was 1.9±1.3, mean duration of
Hospitalization in ICU (mechanically ventilated patient )
was 28.1± 15.9 days and its frequency was 3.1± 1.7, and
mean duration of Hospitalization in ICU ( not
mechanically ventilated patient ) was 22 ± 12.2 days and
its frequency was 2.7±1.
5. There is highly significant statistical difference between
COPD patients with co morbid diseases and COPD
patients without co morbid diseases as regard duration of
Hospitalization and frequency of Hospitalization, cases
Summary and Conclusion
103
without co morbid diseases that with mean of frequency
of Hospitalization 2.1±1.4 in comparison with cases with
co-morbid disease that with mean of frequency of
Hospitalization 2.7 ± 1.3.
6. The current study, shows highly significant statistical
difference in total cost of medications of COPD patient
who discharged from chest department with mean L.E
488.6 ±SD L.E 303.1, Total cost of COPD patient who
discharged from ICU (mechanically ventilated patient)
with mean L.E 1075.7± SD L.E 505.5, Total cost of
COPD patient who discharged from ICU (not
mechanically ventilated patient) with mean L.E 874.5 ±
SD L.E 582.4.
7. The current study, shows highly significant statistical
difference in total cost of medications of COPD patient
who received inhaled and systemic steroid with mean L.E
999.9± SD L.E 693.5, and who received inhaled steroid
only with mean L.E 789.1 ±SD L.E 418.9, compared
with who not received any steroid with mean L.E
517.5±SD L.E 338.5.
8. There is highly significant statistical difference as regard
duration of hospitalization between patients of COPD
who received inhaled and systemic steroid with mean
23.1, received inhaled steroid only with mean 21.4 and
Summary and Conclusion
104
not received any steroid with mean 13.4, but no
significant statistical difference as regard frequency of
exacerbations between patients of COPD who received
inhaled and systemic steroid, received inhaled steroid
only and not received any steroid.
from the present study it was concluded that:
1. The Costs of treatment increase with the severity of
COPD or with progression to a higher stage.
2. The Co-morbidities with COPD patients increase
frequency of Hospitalization and its duration.
3. The Co-morbidities with COPD patients increase risk of
Mechanical ventilation in COPD exacerbation.
4. Long term steroid treatment increase Cost of COPD
management as increase duration of hospitalization and
risk of Co-morbidities