RECURRENT RESPIRATORY-INFECTIONS IN PATIE NTS WITH CHRONIC OBSTRUCTIVE BRONCHITIS - MEDICAL-MANAGEMENT AND COSTS

The objective of this study is to describe usual medical management an d costa associated with recurrent respiratory infections in subjects w ith chronic obstructive bronchitis in France. A prospective survey was performed in Autumn 1994 on a national sample of private practice pul monologists (N = 71). Two hundred forty-four patients, presenting at l east one infection of the lower respiratory tract, were included. Bron chitis was the most frequent acute exacerbation observed (94%). Pneumo nia concerned 9% of the patients. Biological tests, X-rays and pulmona ry function tests were prescribed for, respectively, 59, 65 and 45% of the patients. Following the visit, 15 patients were hospitalized (6%) . The direct medical cost per acute exacerbation was estimated 3,289 f rancs (1994 value) of which 60% were hospital-related. An average 10.4 day sick-leave was prescribed to 21% of patients in employment. For t hose patients, this sick-leave was associated to an extra-cost of 1,26 4-1,876 francs for Social Security and of 0-2,553 francs out of pocket per episode varying according to their Benefit Regimen.