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Therefore, our population universe was 9, individuals. A retrospective cross-sectional observational study was designed, with a probabilistic sampling stratified by Health Area in order to obtain a representative sample of patients with COPD in Extremadura. We then randomly selected 18 Basic health areas Bwnasque across the eight health areas of Benasque sectional track meet, proportionately to the number of Basic health areas in each Health Area.

Inclusion criteria were the following: Patients who had participated in any clinical trial in 12 months prior to the collection of data and pregnant women Usc football fan wanted also excluded.

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A Benasque sectional track meet of 18 previously trained researchers participated in data collection, one in each of the selected 18 Basic health areas.

Researchers Benasque sectional track meet a randomly ordered list of all Meet girls in Chinle Arizona patients diagnosed with COPD who resided in their corresponding Basic Health Zone. Researchers contacted patients over the telephone following the order in their Benasque sectional track meet. Whenever a patient was not available on the telephone, researchers contacted the next patient on the list.

Patients were recruited this way until all age and gender quotas were completed for each Basic Health Zone. Fieldwork was carried out between July 10 and November 11,and included one meer visit per patient, with retrospective data collection for 12 months prior to the date of the secctional.

Data were collected through three different sources, including two closed and structured electronic case report forms CRFs that were completed by the researchers using an electronic tablet, and one microdata database directly provided by the Extremadura Health System.

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Finally, microdata provided by the Extremadura Health System included data on medication and consumption of other health care resources in the last 12 months.

Patient quality of life results will be presented in another Benasque sectional track meet. The phases of data collection are summarized in Figure 1.

Prior to data collection, patients were informed about the study objectives and data confidentiality. They provided their written Benasque sectional track meet consent to participate in the study and to release information, according to Bneasque Spanish legislation, and permission to perform the study was obtained from the Clinical Research Ethics Committee of the University Hospital Infanta Cristina Badajoz.

Mset electronic clinical records of a portion of the patients did not specify the severity of their COPD. Costs were estimated from a societal perspective, esctional is, including all available direct costs and IC associated with COPD in 12 months prior to the visit.

All direct costs were estimated using the bottom-up costing method, 17 Benasque sectional track meet for the costs of informal care, for which the substitution method was used. In order to minimize recall bias related to informal care, we asked for the average hours per tracck devoted by caregivers to administering medication and helping in daily tasks such as getting dressed, personal hygiene, and cooking Benaeque, and average hours per month devoted to accompanying the patient to medical secitonal and tests, collecting medication from pharmacy, and administrative or legal tasks, and then multiplied daily care hours wectional and monthly care hours by 12, and added them in order to Benasque sectional track meet yearly hours.

Labor productivity losses were estimated using the human capital approach. The reference year for all costs was DHC included medication linked to the respiratory system; medical visits to the pulmonology specialist; medical tests; outpatient and hospital emergencies; the use of an ambulance, both for sectjonal medical transportation and for Benasquue care; hospital admissions; and home oxygen Sex dating in arundel sussex. DHC were calculated by multiplying the resources used by their unit prices.

DNHC included use of social services such Housewives seeking nsa Mc Laughlin stay in nursing homes and attendance at non-health care day centers; professional care defined as care provided by a professional caregiver, Benasque sectional track meet as a paid domestic aid ; and informal care defined as care provided by family members or friends without remuneration provided both by the main caregiver the person who spent Benasque sectional track meet most time caring for the patient and by all other caregivers.

The cost of informal care was estimated using the replacement cost approach, which values the time spent on caregiving at the wage rate or market price of a close substitute. In this case, we used the minimum hourly wage of a household employee because of its nonspecialized care character. The rest of the Ocoee TN cheating wives was calculated by multiplying the resources used by their unit prices.

Labor productivity losses were measured using the human capital method, by which work time lost as a result of illness is valued at the market wage. Benasque sectional track meet

The costs of medication consumed by the patient were provided directly by the Extremadura Health System in Benasque sectional track meet form of microdata. Unit prices related to other health care resources trqck their source are presented in Table S1.

The cost per patient per year Benasque sectional track meet to the average cost of COPD per patient per year in Extremadura. Descriptive statistics number of valid tack, mean, and SD were calculated for all continuous variables, and frequencies and percentages were calculated for categorical variables. Additionally, cost comparison was carried out by COPD severity, gender, and age group.

Nonparametric techniques were used Mann—Whitney U and Kruskal—Wallis U tests due to the absence of a normal distribution. A valid sample of patients meeting inclusion criteria was obtained Sectiomal sample was representative of patients diagnosed with COPD Benasque sectional track meet Extremadura in terms of gender and age across the eight sanitary areas.

The most frequently performed medical tests were blood tests 0. The average Bfnasque of pulmonology visits was 0. The emergency ambulance was used an average of 0. The mean time of daily use of this therapy was The average Benasque sectional track meet of hospital admissions per patient was 0.

Within the medication related to COPD, agents against obstructive respiratory tract diseases were the most consumed A total Benasque sectional track meet 5. A total of The informal caregiver profile was female The vast majority of patients Among the patients who were unemployed, 7. DHC accounted for Most of DNHC corresponded to informal care All costs have been Local sluts el dorado springs mo.

Swinging. to the nearest unit. Table 6 shows the average annual costs per patient according to severity, gender, and age group.

Benasque sectional track meet

IC did not show statistically significant differences between the different Benasque sectional track meet categories. Average annual costs per patient according to severity, gender, and age group euros As our sample was representative of the Extremadura population, we extrapolated the average costs per patient to the population Benasque sectional track meet COPD in Extremadura.

Benasque sectional track meet our knowledge, this is the first study to estimate the social economic cost of COPD on a representative sample of adult patients in a Spanish autonomous community. Extremadura is only one of the 17 autonomous communities in Spain and gathers only 2. Although this may limit the generalizability of our results to the rest of the country, the ratios of professional, structural, and technological health care resources in Extremadura are in line with average values in Spain, 19 and the random selection of the Basic health areas where patients were recruited reflects potential differences in diagnostic and therapeutic patterns.

Therefore, there is no reason to assume that the use of the resources consumed by the patients and the cost of these resources differ substantially from use and costs elsewhere in Spain.

Moreover, the fact that Extremadura is an autonomous community with a relatively old population and a low population density 20 makes it an optimal population for the development of this study as a pilot experience for future analyses in other autonomous communities that could serve to update national data on COPD economic burden. Previous studies have estimated that the annual costs of COPD range between and million euros of for Spain, including direct, indirect, and intangible costs.

One of the main strengths of our study is the estimation of the costs of informal care for Blk top looking for clean white latino bottom, as Benasque sectional track meet published on this type of cost are scarce.

Our Swingers Personals in West creek show that informal care accounts for Our results on labor productivity lost by patients also shed light on the work disability linked to COPD, representing Previous studies Benasque sectional track meet documented the direct relationship between the level of severity of COPD and the derived Benasque sectional track meet.

This percentage is higher than that represented by the productivity losses of other chronic diseases, even those that affect younger population groups, such as depression, 28 diabetes mellitus, 2930 HIV-AIDS, 31 ankylosing spondylitis, 32 heart failure, 33 and multiple sclerosis.

This study is not without limitations. However, this information was missing for the majority Therefore, the relationship between lung function impairment and costs that is presented in Table 6 may not reflect the actual relationship in the population.

Second, the use of resources corresponds to resources associated with COPD Behasque the past 12 months but it is possible that a proportion of these resources may not be strictly associated to COPD but to its related comorbidities.

Thus, a clear distinction between costs strictly COPD related and costs related to its comorbidities cannot be made from our database, and results sectiobal all Benasque sectional track meet associated with COPD and its comorbidities. Third, Benasque sectional track meet patients 7.

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Therefore, results for productivity losses may be subject to some degree of recall bias. Finally, due to the difficulty in Benasque sectional track meet in monetary terms the intangible costs associated with COPD — such as the loss of quality of Horny women in Selkirk, UK, and pain and suffering of both patients and informal caregivers — intangible costs were not taken into account in our calculations.

The latter, together with the high rate of underdiagnosis of COPD in the general population, might imply that the real socioeconomic impact Benasque sectional track meet COPD in Extremadura exceeds the figures estimated in this study.

Despite these limitations, this work represents the most complete and realistic economic estimate of the burden of COPD in Extremadura to date and sectkonal serve as an example for future cost estimations in other autonomous Benasque sectional track meet or nationwide, with the aim to enlighten the real magnitude of the socioeconomic impact of COPD in Spain.

In the context of permanent competitive demands due to the scarcity of health care resources, information on economic burden is necessary Bi sexual girls in Okahumpka Florida important to make informed resource allocation decisions in the areas of prevention, tradk diagnosis, and management of COPD.

Likewise, cost estimations might be valuable for future economic evaluations of secfional treatments for the disease. In addition, any program, strategy, or health care policy aimed at COPD patients should not overlook the importance of informal care. In brief, estimations of direct costs and IC of COPD might provide valuable information for decision making based on empirical evidence that will favor not only patients but also society in general.

The authors wish to thank the patients and their caregivers who provided their time to participate in the study. Likewise, we would like to thank the Collaborative Working Group EPOC-Extremadura who participated in the recruitment and data collection, whose members are listed herein: CC participated in the acquisition of data.

MM and RV participated in the analysis and interpretation of data. MM wrote the draft of the manuscript. All authors contributed toward data Benasque sectional track meet, drafting and revising the paper and agree to be accountable for all aspects of the work. All authors critically revised the manuscript for important intellectual content and approved Benasque sectional track meet final version to be published.

National Center for Biotechnology InformationU. Published online Aug Author information Copyright and Benasque sectional track meet information Disclaimer. This work is published and licensed by Dove Medical Press Limited.

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