Active tobacco smoking as determinant of costs of inpatient treatment of COPD exacerbations

The aim of the study was assessment of the influence of tobacco smoking on direct costs of in-hospital treatment of chronic obstructive pulmonary disease exacerbations (COPD). 112 men who underwent in-hospital treatment of exacerbation of moderate COPD in the years 2001-2002 were included in the study. The patients were qualified into one of three groups: I--never-smoking patients (n=40); II--former smokers (n=42); III--active smokers (n=30). The mean age of patients was 70.9 +/- 8.9 years (I--74.8 +/- 7.4; II--68.4 +/- 9.4; III--69.4 +/- 9.8). The mean direct cost of COPD patient treatment was PLN 2162.00 +/- 920.90 (I--PLN 2025.50 +/- 681.30; II--PLN 1875.80 +/- 608.70; III--PLN 2744.60 +/- 1266.20). The mean period of smoking was 18.3 pack-years in the group II and 27.7 pack-years in the group III. No significant differences in FEV1 were found between the groups. No significant differences were found in the treatment costs between the groups I and II. It was demonstrated that the costs of in-hospital COPD treatment are significantly higher in the group III than in the groups I and II. A linear regression formula was calculated, showing a linear relationship between each consecutive pack-year of addiction and the costs of exacerbation treatment in the group III (R=0.39, R2=0.13, standardized BETA index = 24.0; p<0.03). No similar relationship was found in the former smokers' group. The analysis of the data shows that: (1) active tobacco smoking by patients is related to significantly higher direct costs of in-hospital treatment of COPD exacerbations than in case of never-smoking patients or patients who smoked in the past, and (2) the costs of in-hospital treatment of COPD exacerbations in case of people who have stopped smoking are comparable to the costs of hospitalization of never-smoking patients with COPD.