Using the BODE Index and Comorbidities to Predict Health Utilization Resources in Chronic Obstructive Pulmonary Disease

Abstract

Background and Objective

Chronic Obstructive Pulmonary Disease (COPD) is a common chronic respiratory disease that in the long term may develop into respiratory failure or even cause death and may coexist with other diseases. Over time, it may incur huge medical expenses, resulting in a heavy socio-economy burden. The BODE (Body mass index, airflow Obstruction, Dyspnea, and Exercise capacity) index is a predictor of the number and severity of acute exacerbations of COPD. This study focused on the correlation between the BODE index, comorbidity, and healthcare resource utilization in COPD.

Patients and Methods

This is a retrospective study of clinical outcomes of COPD patients with complete BODE index data in our hospital from January 2015 to December 2016. Based on the patients’ medical records in our hospital’s electronic database from January 1, 2015 to August 31, 2017, we analyzed the correlation between BODE index, Charlson comorbidity index (CCI), and medical resources.

Results

Of the 396 patients with COPD who met the inclusion criteria, 382 (96.5%) were male, with an average age of 71.3 ± 8.4 years. Healthcare resource utilization was positively correlated with the BODE index during the 32 months of retrospective clinical outcomes. The study found a significant association between the BODE index and the CCI of COPD patients ( p < 0.001). In-hospitalization expenses were positively correlated with CCI ( p < 0.001). Under the same CCI, the higher the quartile, the higher the hospitalization expenses. BODE quartiles were positively correlated with number of hospitalizations ( p < 0.001), hospitalization days ( p < 0.001), hospitalization expenses ( p = 0.005), and total medical expenses ( p = 0.024).

Conclusion

This study demonstrates the value of examining the BODE index and comorbidities that can predict healthcare resource utilization in COPD.