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dc.contributor.authorCollins, Peter F
dc.contributor.authorStratton, Rebecca J
dc.contributor.authorKurukulaaratchy, Ramesh J
dc.contributor.authorElia, Marinos
dc.date.accessioned2020-02-24T04:15:23Z
dc.date.available2020-02-24T04:15:23Z
dc.date.issued2018
dc.identifier.issn1178-2005
dc.identifier.doi10.2147/COPD.S157594
dc.identifier.urihttp://hdl.handle.net/10072/391831
dc.description.abstractBackground and aim: Deprivation is associated with the incidence of COPD, but its independent impact on clinical outcomes is still relatively unknown. This study aimed to explore the influence of deprivation on health care use, costs, and survival. Methods: A total of 424 outpatients with COPD were assessed for deprivation across two hospitals. The English Index of Multiple Deprivation (IMD) was used to establish a deprivation score for each patient. The relationship between deprivation and 1-year health care use, costs, and mortality was examined, controlling for potential confounding variables (age, malnutrition risk, COPD severity, and smoking status). Results: IMD was significantly and independently associated with emergency hospitalization (β-coefficient 0.022, SE 0.007; p=0.001), length of hospital stay, secondary health care costs (β-coefficient £101, SE £30; p=0.001), and mortality (HR 1.042, 95% CI 1.015–1.070; p=0.002). IMD was inversely related to participation in exercise rehabilitation (OR 0.961, 95% CI 0.930–0.994; p=0.002) and secondary care appointments. Deprivation was also significantly related to modifiable risk factors (smoking status and malnutrition risk). Conclusion: Deprivation in patients with COPD is associated with increased emergency health care use, health care costs, and mortality. Tackling deprivation is complex; however, strategies targeting high-risk groups and modifiable risk factors, such as malnutrition and smoking, could reduce the clinical and economic burden.
dc.description.peerreviewedYes
dc.languageEnglish
dc.language.isoeng
dc.publisherDove Medical Press
dc.relation.ispartofpagefrom1289
dc.relation.ispartofpageto1296
dc.relation.ispartofjournalInternational Journal of Chronic Obstructive Pulmonary Disease
dc.relation.ispartofvolume13
dc.subject.fieldofresearchCardiovascular medicine and haematology
dc.subject.fieldofresearchcode3201
dc.subject.keywordsScience & Technology
dc.subject.keywordsLife Sciences & Biomedicine
dc.subject.keywordsRespiratory System
dc.subject.keywordsCOPD
dc.subject.keywordseconomics
dc.titleInfluence of deprivation on health care use, health care costs, and mortality in COPD
dc.typeJournal article
dc.type.descriptionC1 - Articles
dcterms.bibliographicCitationCollins, PF; Stratton, RJ; Kurukulaaratchy, RJ; Elia, M, Influence of deprivation on health care use, health care costs, and mortality in COPD, International Journal of Chronic Obstructive Pulmonary Disease , 2018, 13, pp. 1289-1296
dcterms.licensehttp://creativecommons.org/licenses/by-nc/3.0/
dc.date.updated2020-02-24T04:12:27Z
dc.description.versionVersion of Record (VoR)
gro.rights.copyright© 2018 Collins et al. This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php)
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gro.griffith.authorCollins, Peter


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