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Older Adults With COPD and Lung Cancer: Costs, Health Care Utilization


June 14, 2018

Pre-existing chronic obstructive pulmonary disease (COPD) significantly boosts healthcare use, and subsequently costs, among older adults with non-small cell lung cancer, according to a study published online in the Journal of Medical Economics (doi: 10.1080/13696998.2018.1484370).

“Healthcare utilization and costs among lung cancer patients with pre-existing COPD was approximately 2 to 3 times higher than the non-COPD group,” researchers reported.

The study used SEER-Medicare data to identify patients with lung cancer age 66 and older. Researchers looked at inpatient hospitalizations, skilled nursing facility use, physician office visits, emergency department visits, and outpatient encounters during each stage of lung cancer for patients with pre-existing COPD and compared them with those for patients without COPD.

With each stage of lung cancer, researchers found, inpatient admissions were higher among patients with COPD. Per 100 person-months, admissions during stage I were 14.67 stays with COPD vs 9.49 stays without; stage II, 14.13 stays with COPD vs 10.78 stays without; stage III, 28.31 stays with COPD vs 18.91 stays without; and stage IV, 49.5 stays with COPD vs 31.24 stays without.

Outpatient visits demonstrated a similar trend, the study showed. During stage I lung cancer, there were 1136.04 visits among patients with COPD vs 796 visits among patients without; stage II, 1325.12 visits with COPD vs 983.26 visits without; stage III, 2025.47 visits with COPD vs 1656.64 visits without; and stage IV, 2825.73 visits with COPD vs 2422.26 visits without.

Total direct costs per person-month were $54,799.16 for older adults with pre-existing COPD compared with $41,862.91 for older adults without COPD, according to the study. The largest cost category across all services in both groups was outpatient visits, totaling $41,203 for patients with COPD and $31,140.08 for patients without COPD.

Jolynn Tumolo


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