OBJECTIVE To investigate the characteristics and medical expenditures of patients with Asthma- chronic obstructive pulmonary disease (COPD) overlap (ACO) compared to asthma and COPD patients. METHODS This was a retrospective cohort study involving patients diagnosed with ACO, asthma or COPD as of January 2016. Medical records for patients attending King Abdullah University Hospital (KAUH), in northern Jordan, during the years 2015-2016 were used to identify eligible patients and all relevant clinical characteristics. Both respiratory and all-cause charges were extracted from KAUH billing system during the year 2016. Total, inpatient, outpatient, and pharmacy charges were described and compared across the three disease categories. Charges were measured in Jordanian Dinar (JOD, equal to 1.41 US Dollar). RESULTS Of a total of 761, 87 ACO patients, 494 asthmatic patients and 180 COPD patients were identified and included in this study. The average total respiratory-related charges were significantly higher in patients with ACO compared to patients with asthma (601.4 versus 354.3 JODs; P value < 0.001). Average all-cause charges were higher in case of ACO and COPD compared to patients with asthma (1830.8 and 1705.4 versus 1251.7 JODs; P value < 0.001). ACO was a significant predictor of higher respiratory and all-cause related charges. Respiratory charges were also higher in older patients and those with higher disease severity. CONCLUSIONS ACO is a risk factor for incurring higher health expenditures in Jordan. Higher respiratory expenditures are also associated with older ages and higher disease severity.

中文翻译：

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在约旦北部，哮喘-COPD 的健康支出重叠。

目的 调查哮喘-慢性阻塞性肺疾病（COPD）重叠（ACO）患者与哮喘和慢性阻塞性肺病患者相比的特征和医疗费用。方法 这是一项回顾性队列研究，涉及截至 2016 年 1 月诊断为 ACO、哮喘或 COPD 的患者。使用 2015-2016 年在约旦北部阿卜杜拉国王大学医院 (KAUH) 就诊的患者的医疗记录来确定符合条件的患者以及所有相关的临床特征。2016 年期间，呼吸系统和全因费用均从 KAUH 计费系统中提取。对三种疾病类别的总费用、住院费用、门诊费用和药房费用进行了描述和比较。费用以约旦第纳尔（JOD，等于 1.41 美元）计算。结果 在总共 761 名、87 名 ACO 患者中，494 名哮喘患者和 180 名 COPD 患者被确定并纳入本研究。与哮喘患者相比，ACO 患者的平均呼吸相关总费用显着更高（601.4 对 354.3 JOD；P 值 < 0.001）。与哮喘患者相比，ACO 和 COPD 患者的平均全因费用更高（1830.8 和 1705.4 对 1251.7 JOD；P 值 < 0.001）。ACO 是较高的呼吸和全因相关费用的重要预测指标。老年患者和疾病严重程度较高的患者的呼吸费用也较高。结论 ACO 是导致约旦卫生支出增加的风险因素。较高的呼吸支出也与年龄较大和疾病严重程度较高有关。