Socioeconomic relevance of acute exacerbations of chronic bronchitis in the Federal Republic of Germany

Background and objective: Prospectively determined data on costs of chronic bronchitis were not yet available for the Federal Republic of Germany. The purpose of the burden-of-illness-study conducted in the Federal Republic o f Germany from October 1996 to March 1998 was to calculate direct and indir ect costs of chronic bronchitis as well as its acute exacerbations per pati ent and year. Furthermore, the health-related quality of life of the patien ts was determined. Patients and methods: The burden-of-illness-study was conducted as an open, not randomised surveillance study. The evaluation based on 785 patients (5 5,4% male, 44,2% female, 0,4% unknown; mean age 60 years) who were treated by 147 general practitioners. 755 patients could be included into the cost analysis. Results: Per patient and year direct costs of chronic bronchitis amounted t o DM 1112.27, the calculation of indirect costs resulted in DM 959.09. 41.4 % of direct costs were due to drug acquisition, hospitalization costs share d 31.6% and costs for physicians' fee amounted to 20.6%. The severity of ch ronic bronchitis revealed significantly different results in cost analysis: per patient, mild disease lead to direct costs of DM 387.86, moderate dise ase to DM 802.62 and severe disease to DM 2224.40. This result was caused b y higher costs for drug acquisition and hospitalisation costs due to chroni c bronchitis in higher stages of severity. Indirect costs were calculated b y applying the human-capital-approach: 45.8% of indirect costs were due to time-off-work, nursing cost!; amounted to 23.7%. Conclusion: The cc,sts of chronic bronchitis have a considerable impact on the total costs of the health care system of Germany.