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The following is a summary of “DOSE index in chronic obstructive pulmonary disease: evaluating healthcare costs,” published in the November 2024 issue of Pulmonology by Li et al. 

The DOSE index, which includes Dyspnea, Obstruction, Smoking, and Exacerbations, was widely used to evaluate the severity and prognosis of Chronic Obstructive Pulmonary Disease (COPD), with potential clinical utility in predicting healthcare costs driven by exacerbations despite the absence of dedicated tools for forecasting such expenses.  

Researchers conducted a retrospective study to assess the predictive performance of the DOSE index compared to Body-mass index, Obstruction, Dyspnea, Exercise (BOD), Age, Dyspnea, Obstruction (ADO), and Charlson Comorbidity Index (CCI) for healthcare costs in patients with COPD.  

They analyzed data from 396 COPD cases and examined associations between the DOSE index, BODE index, ADO index, CCI, and healthcare costs, including hospitalizations and emergency room treatments. Healthcare costs were categorized as direct medical expenses.  

The results showed significant associations between the DOSE index and healthcare parameters. Higher DOSE quartiles correlated with more outpatient visits (P = 0.013) and higher outpatient expenses (P = 0.011). Hospitalization frequency, duration, and costs were also significantly linked to higher DOSE quartiles (P < 0.001). A significant difference was observed in DOSE quartiles between patients with high (CCI ≥ 3) and low (CCI < 3) comorbidity scores (P = 0.018), and it also outperformed other indices due to its inclusion of exacerbations.   

Investigators concluded that the DOSE index, incorporating exacerbation frequency, showed the potential to predict healthcare costs in patients with COPD.   

Source: bmcpulmmed.biomedcentral.com/articles/10.1186/s12890-024-03368-0