ORIGINAL ARTICLE
IMPACT OF THE ECONOMIC AVAILABILITY OF LONG-TERM OXYGEN THERAPY ON THE HEALTH STATUS OF PATIENTS WITH COPD: A CROSS-SECTIONAL STUDY

UDK: 616.24-002.2-085.816.2

Arbutina S¹, Todevski D¹,  Pejkovska S¹, Zdraveska M¹, Dimitrievska D1, Zejnel S¹

 

1PHI University Clinic of Pulmonology and Allergology- Skopje, Mother Teresa 17, 1000 Skopje

 

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is a progressive respiratory condition characterized by persistent airflow limitation, chronic inflammation, and represents a significant burden globally. Long-term oxygen therapy (LTOT) improves survival, reduces exacerbations, and enhances health-related quality of life (HRQoL) among patients with severe hypoxemia.  However, economic constraints in many health systems restrict access to LTOT, potentially exacerbating symptom burden and the overall functional decline. This study evaluates whether economic inaccessibility to LTOT is associated with differences in symptoms and perceived health status among COPD patients who meet clinical criteria for LTOT.

Material and methods: A cross-sectional study was conducted involving 60 adults with COPD who met physiological criteria for LTOT. Participants were divided into two groups: LTOT users (n = 30) and LTOT non-users (n = 30) who could not obtain therapy due to financial limitations. Symptoms and health status were assessed using the COPD Assessment Test (CAT). Statistical analyses included t-tests, Mann–Whitney U tests, chi-square tests, and Cohen’s d.

Results: Patients without access to LTOT demonstrated higher CAT scores, indicating worse symptom burden and lower health status. Although the mean difference did not reach statistical significance, the effect size suggested a small-to-moderate clinically meaningful trend favoring LTOT users. A higher proportion of LTOT non-users fell into the very high impact CAT severity band.

Conclusion: Economic barriers to LTOT access may contribute to poorer symptom control and diminished quality of life in COPD patients who meet established criteria for oxygen therapy. Addressing financial constraints through policy reforms may improve equity in COPD care and reduce disease burden.

 

Keywords: Chronic obstructive pulmonary disease; Long-term oxygen therapy; Chronic obstructive pulmonary disease Assessment Test.

 

 

 

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