Insomnia in chronic obstructive pulmonary disease and associations with healthcare utilization and costs
Abstract Insomnia has been linked to adverse chronic obstructive pulmonary disease (COPD) outcomes including exacerbations, yet its impact on COPD-related healthcare utilization and costs is unknown. In this study, we investigated the associations between insomnia and healthcare utilization and cost...
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| Format: | Article |
| Language: | English |
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BMC
2023-03-01
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| Series: | Respiratory Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12931-023-02401-w |
| _version_ | 1797859807680528384 |
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| author | Faith S. Luyster Monique Y. Boudreaux-Kelly Jessica M. Bon |
| author_facet | Faith S. Luyster Monique Y. Boudreaux-Kelly Jessica M. Bon |
| author_sort | Faith S. Luyster |
| collection | DOAJ |
| description | Abstract Insomnia has been linked to adverse chronic obstructive pulmonary disease (COPD) outcomes including exacerbations, yet its impact on COPD-related healthcare utilization and costs is unknown. In this study, we investigated the associations between insomnia and healthcare utilization and costs in patients with COPD. A retrospective cohort of veterans with COPD were identified from national Veterans Affairs administration data for fiscal years 2012–2017. Insomnia was operationalized as having an insomnia diagnosis based on International Classification of Disease codes or having a prescription of > 30 doses of a sedative-hypnotic medication in a given fiscal year. The index date for insomnia was the first date when dual criteria for COPD and insomnia was met. The index date for those without insomnia was set as the COPD index date. Our primary outcomes were 1-year healthcare utilization and costs related to outpatient visits and hospitalizations after index date. COPD-related healthcare utilization variables included number of prescription fills of corticosteroids and/or antibiotics and outpatient visits and hospitalizations with a primary diagnosis of COPD. Out of 1,011,646 patients (96% men, mean age 68.4 years) diagnosed with COPD, 407,363 (38.8%) had insomnia. After adjustment for confounders, insomnia was associated with higher rates of outpatient visits, hospitalizations, and fills for corticosteroids and/or antibiotics, longer hospital length of stay, and $10,344 higher hospitalization costs in the 12 months after index date. These findings highlight the importance of insomnia as a potentially modifiable target for reducing the burden of COPD on patients and healthcare systems. |
| first_indexed | 2024-04-09T21:36:37Z |
| format | Article |
| id | doaj.art-33e035bff26548ea8befe15cae151be8 |
| institution | Directory Open Access Journal |
| issn | 1465-993X |
| language | English |
| last_indexed | 2024-04-09T21:36:37Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Respiratory Research |
| spelling | doaj.art-33e035bff26548ea8befe15cae151be82023-03-26T11:16:21ZengBMCRespiratory Research1465-993X2023-03-012411810.1186/s12931-023-02401-wInsomnia in chronic obstructive pulmonary disease and associations with healthcare utilization and costsFaith S. Luyster0Monique Y. Boudreaux-Kelly1Jessica M. Bon2School of Nursing, University of PittsburghVA Pittsburgh Healthcare SystemVA Pittsburgh Healthcare SystemAbstract Insomnia has been linked to adverse chronic obstructive pulmonary disease (COPD) outcomes including exacerbations, yet its impact on COPD-related healthcare utilization and costs is unknown. In this study, we investigated the associations between insomnia and healthcare utilization and costs in patients with COPD. A retrospective cohort of veterans with COPD were identified from national Veterans Affairs administration data for fiscal years 2012–2017. Insomnia was operationalized as having an insomnia diagnosis based on International Classification of Disease codes or having a prescription of > 30 doses of a sedative-hypnotic medication in a given fiscal year. The index date for insomnia was the first date when dual criteria for COPD and insomnia was met. The index date for those without insomnia was set as the COPD index date. Our primary outcomes were 1-year healthcare utilization and costs related to outpatient visits and hospitalizations after index date. COPD-related healthcare utilization variables included number of prescription fills of corticosteroids and/or antibiotics and outpatient visits and hospitalizations with a primary diagnosis of COPD. Out of 1,011,646 patients (96% men, mean age 68.4 years) diagnosed with COPD, 407,363 (38.8%) had insomnia. After adjustment for confounders, insomnia was associated with higher rates of outpatient visits, hospitalizations, and fills for corticosteroids and/or antibiotics, longer hospital length of stay, and $10,344 higher hospitalization costs in the 12 months after index date. These findings highlight the importance of insomnia as a potentially modifiable target for reducing the burden of COPD on patients and healthcare systems.https://doi.org/10.1186/s12931-023-02401-wSleep initiation and maintenance DisordersPulmonary DiseaseChronic Obstructive |
| spellingShingle | Faith S. Luyster Monique Y. Boudreaux-Kelly Jessica M. Bon Insomnia in chronic obstructive pulmonary disease and associations with healthcare utilization and costs Respiratory Research Sleep initiation and maintenance Disorders Pulmonary Disease Chronic Obstructive |
| title | Insomnia in chronic obstructive pulmonary disease and associations with healthcare utilization and costs |
| title_full | Insomnia in chronic obstructive pulmonary disease and associations with healthcare utilization and costs |
| title_fullStr | Insomnia in chronic obstructive pulmonary disease and associations with healthcare utilization and costs |
| title_full_unstemmed | Insomnia in chronic obstructive pulmonary disease and associations with healthcare utilization and costs |
| title_short | Insomnia in chronic obstructive pulmonary disease and associations with healthcare utilization and costs |
| title_sort | insomnia in chronic obstructive pulmonary disease and associations with healthcare utilization and costs |
| topic | Sleep initiation and maintenance Disorders Pulmonary Disease Chronic Obstructive |
| url | https://doi.org/10.1186/s12931-023-02401-w |
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