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Abstract Summary and Conclusion Chronic obstructive pulmonary disease (COPD) is a highly prevalent and debilitating disease that has a significant impact on patient quality of life and the costs borne by the health care system. An exacerbation of COPD is the most common condition that requires hospital admission, and contributes substantially to the related economic impact. Therefore, COPD exacerbations have been considered the most important target for reducing costs. A study in the UK National Health Service (NHS) in 2001 showed that the total excess primary care cost associated with acute exacerbations of chronic bronchitis in the COPDdiagnosed population was £35.7 million. This included the excess cost of all prescription medications, general practitioner (GP). (Nurmatov et al., 2012) The aim of this study was to compare the Cost of COPD exacerbations managed in Hospital as regard (Hospital stay, Antibiotic, Chest Medication, Medications of Co-morbid diseases) with COPD managed in Outpatient Clinic. Summary and Conclusion 101 The present study was conducted on (74) male patients divided to 3 groups: Group A: consist of COPD patients with acute exacerbation managed in Chest department. Group B: consist of COPD patients with acute exacerbation managed in Respiratory ICU and received mechanical ventilation. Group C: consist of COPD patients with acute exacerbation managed in Respiratory ICU without mechanical ventilation. All patients were followed after discharge as regard The Cost of their medications. The results obtained were collected, tabulated and submitted for statistical analysis. from the present study the following results were obtained: 1. There is significant statistical difference between total cost of medications of COPD patients without co morbid diseases, and total cost of medications of COPD patients with Co morbid diseases. 2. There is highly significant statistical difference as regard Total Cost of medications of COPD patients treated in Summary and Conclusion 102 chest department versus patients treated Respiratory ICU (either mechanically ventilated or not). 3. The Cost of Antibiotic increased proportionately with the increase of severity of COPD patient, as the main cost of patients treated in chest department was L.E 1259.7± SD E.L 1256.2) and the main cost of patients treated in Respiratory ICU (mechanically ventilated) was L.E 4970.7 ± SD L.E 3807.4, the main cost of patients treated in respiratory ICU (not mechanically ventilated ) was L.E 2627.8 ±1777.3. 4. There is highly significant statistical difference between studied groups as regard duration of Hospitalization and frequency of Hospitalization with mean duration of Hospitalization in chest department was 12.2±5.6 days and its frequency was 1.9±1.3, mean duration of Hospitalization in ICU (mechanically ventilated patient ) was 28.1± 15.9 days and its frequency was 3.1± 1.7, and mean duration of Hospitalization in ICU ( not mechanically ventilated patient ) was 22 ± 12.2 days and its frequency was 2.7±1. 5. There is highly significant statistical difference between COPD patients with co morbid diseases and COPD patients without co morbid diseases as regard duration of Hospitalization and frequency of Hospitalization, cases Summary and Conclusion 103 without co morbid diseases that with mean of frequency of Hospitalization 2.1±1.4 in comparison with cases with co-morbid disease that with mean of frequency of Hospitalization 2.7 ± 1.3. 6. The current study, shows highly significant statistical difference in total cost of medications of COPD patient who discharged from chest department with mean L.E 488.6 ±SD L.E 303.1, Total cost of COPD patient who discharged from ICU (mechanically ventilated patient) with mean L.E 1075.7± SD L.E 505.5, Total cost of COPD patient who discharged from ICU (not mechanically ventilated patient) with mean L.E 874.5 ± SD L.E 582.4. 7. The current study, shows highly significant statistical difference in total cost of medications of COPD patient who received inhaled and systemic steroid with mean L.E 999.9± SD L.E 693.5, and who received inhaled steroid only with mean L.E 789.1 ±SD L.E 418.9, compared with who not received any steroid with mean L.E 517.5±SD L.E 338.5. 8. There is highly significant statistical difference as regard duration of hospitalization between patients of COPD who received inhaled and systemic steroid with mean 23.1, received inhaled steroid only with mean 21.4 and Summary and Conclusion 104 not received any steroid with mean 13.4, but no significant statistical difference as regard frequency of exacerbations between patients of COPD who received inhaled and systemic steroid, received inhaled steroid only and not received any steroid. from the present study it was concluded that: 1. The Costs of treatment increase with the severity of COPD or with progression to a higher stage. 2. The Co-morbidities with COPD patients increase frequency of Hospitalization and its duration. 3. The Co-morbidities with COPD patients increase risk of Mechanical ventilation in COPD exacerbation. 4. Long term steroid treatment increase Cost of COPD management as increase duration of hospitalization and risk of Co-morbidities |