Supplementary Material for: Cost of Hospitalizations due to Exacerbation in Patients with Non-Cystic Fibrosis Bronchiectasis

Background: Knowing the cost of hospitalizations for exacerbation in bronchiectasis patients is essential to perform cost-effectiveness studies of treatments that aim to reduce exacerbations in these patients. Objectives: To find out the mean cost of hospitalizations due to exacerbations in bronchiectasis patients, and to identify factors associated with higher costs. Methods: Prospective, observational, multicenter study in adult bronchiectasis patients hospitalized due to exacerbation. All expenses from the patients’ arrival at hospital to their discharge were calculated: diagnostic tests, treatments, transferals, home hospitalization, admission to convalescence centers, and hospitals’ structural costs for each patient (each hospital’s tariff for emergencies and 70% of the price of a bed for each day in a hospital ward). Results: A total of 222 patients (52.7% men, mean age 71.8 years) admitted to 29 hospitals were included. Adding together all the expenses, the mean cost of the hospitalization was EUR 5,284.7, most of which correspond to the hospital ward (86.9%), and particularly to the hospitals’ structural costs. The adjusted multivariate analysis showed that chronic bronchial infection by Pseudomonas aeruginosa, days spent in the hospital, and completing the treatment with home hospitalization were factors independently associated with a higher overall cost of the hospitalization. Conclusions: The mean cost of a hospitalization due to bronchiectasis exacerbation obtained from the individual data of each episode is higher than the cost per process calculated by the health authorities. The most determining factor of a higher cost is chronic bronchial infection due to P. aeruginosa, which leads to a longer hospital stay and the use of home hospitalization.

背景：了解支气管扩张症患者因病情恶化而住院的成本对于进行旨在减少这些患者病情恶化的治疗方案的成本效益研究至关重要。目标：探究支气管扩张症患者因病情恶化而住院的平均成本，并识别与高成本相关的因素。方法：一项针对因病情恶化而住院的成年支气管扩张症患者的前瞻性、观察性、多中心研究。计算了患者从入院到出院期间的所有费用：诊断测试、治疗、转移、家庭住院、康复中心入院以及每位患者的医院结构成本（每家医院的急诊费用和医院病房每日床位价格之70%）。结果：共有222名患者（男性占52.7%，平均年龄71.8岁）被纳入29家医院的研究中。将所有费用加总，平均住院成本为5,284.7欧元，其中大部分对应于病房费用（86.9%），尤其是医院的结构成本。调整后的多变量分析显示，铜绿假单胞菌引起的慢性支气管感染、住院天数以及完成家庭住院治疗是独立于其他因素而与更高总体住院成本相关的因素。结论：从每个病例的个体数据中获得的因支气管扩张症病情恶化而发生的平均住院成本高于卫生当局计算的单次过程成本。导致成本较高的最决定性因素是铜绿假单胞菌引起的慢性支气管感染，这导致住院时间延长并需要家庭住院治疗。