Healthcare utilization, medical costs and mortality associated with malnutrition in patients with chronic obstructive pulmonary disease: a matched cohort study

  • Michael Yao Hsien Wang (Creator)
  • Chao-Hsiun Tang (Contributor)
  • Jih Shuin Jerng (Contributor)
  • Kuan Yu Hung (Contributor)
  • Rhoda Wen Yi Cheng (Creator)



<b>Objective:</b> Although disease-related malnutrition has prognostic implications for patients with chronic obstructive pulmonary disease (COPD), its health-economic impact and clinical burdens are uncertain. We conducted a population-level study to investigate these questions. <b>Methods:</b> We excerpted data relevant to malnutrition, prolonged mechanical ventilation and medications from claims by 1,197,098 patients which were consistent with COPD and registered by the Taiwan National Health Insurance Administration between 2009 and 2013. These patients were separated into cohorts with or without respiratory failure requiring long-term mechanical ventilation, and each cohort was divided to compare cases who developed malnutrition after their first diagnosis consistent with COPD, versus non-malnourished propensity-score matched controls. <b>Results:</b> The prevalence of malnutrition was 3.8% overall (10,259/287,000 non-ventilator-dependent; 1198/15,829 ventilator-dependent). Propensity-score matched non-ventilator-dependent patients who became malnourished (<i>N</i> = 10,242) had comparatively more hospitalizations, emergency room and outpatient visits, longer hospitalization (all <i>p</i> N = 40,968). Malnourished ventilator-dependent patients (<i>N</i> = 1197) had higher rates of hospitalization, emergency room and outpatient visits, but shorter hospitalization (all <i>p</i> N = 4788). Total medical expenditure on malnourished non-ventilator-dependent COPD patients was 75% higher than controls (<i>p</i> p <b>Conclusions:</b> Malnourishment among COPD patients who were not dependent on mechanical ventilation was associated with greater healthcare resource utilization and higher aggregate medical costs.
Date made available2019
PublisherTaylor & Francis

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