• JinHee Kim, Chin Kook Rhee, Kwang Ha Yoo, Young Sam Kim, Sei Won Lee, Yong Bum Park, Jin Hwa Lee, YeonMok Oh, Sang Do Lee, Yuri Kim, KyungJoo Kim, and HyoungKyu Yoon.
• Office of Health Service Research, National Evidence-Based Healthcare Collaborating Agency, Seoul, Korea.
• Int J Chron Obstruct Pulmon Dis. 2013 Jan 1;8:561-8.

BackgroundPatients with high grade chronic pulmonary obstructive disease (COPD) account for much of the COPD-related mortality and incur excessive financial burdens and medical care utilization. We aimed to determine the characteristics and medical care use of such patients using nationwide data from the Korean Health Insurance Review and Assessment Service in 2009.Materials And MethodsPatients with COPD were identified by searching with the International Classification of Diseases-10th Revision for those using medication. Patients with high grade COPD were selected based on their patterns of tertiary institute visits and medication use.ResultsThe numbers of patients with high grade COPD increased rapidly in Korea during the study period, and they showed a high prevalence of comorbid disease. The total medical costs were over three times higher in patients with high grade COPD compared with those without it ($3,744 versus $1,183; P < 0.001). Medication costs comprised the largest portion of medical cost, but most impact came from hospitalization and exacerbation in both groups of patients. COPD grade and hospitalization in the previous year were the major factors affecting medical costs and days of utilizing health care resources.ConclusionPatients with high grade COPD impose a high economic burden on the health care system in Korea. Prevention of progression to high grade COPD is important, both clinically and economically.

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