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. 2017 Feb;14(1):72-79.
doi: 10.1080/15412555.2016.1199669. Epub 2016 Jul 15.

Trends in Outcomes, Financial Burden, and Mortality for Acute Exacerbation of Chronic Obstructive Pulmonary Disease (COPD) in the United States from 2002 to 2010

Chetna Jinjuvadia  1 , Raxitkumar Jinjuvadia  2 , Chaitanya Mandapakala  1 , Navin Durairajan  3 , Suthat Liangpunsakul  4 , Ayman O Soubani  1
Affiliations

Trends in Outcomes, Financial Burden, and Mortality for Acute Exacerbation of Chronic Obstructive Pulmonary Disease (COPD) in the United States from 2002 to 2010

Chetna Jinjuvadia et al. COPD. 2017 Feb.

Abstract

Chronic obstructive pulmonary disease (COPD) is the cause of substantial economic and social burden. We evaluated the temporal trends of hospitalizations from acute exacerbation of COPD and determined its outcome and financial impact using the National (Nationwide) Inpatient Sample (NIS) databases (2002-2010). Individuals aged ≥ 18 years were included. Subjects who were hospitalized with primary diagnosis of COPD exacerbation and those who were admitted for other causes but had underlying acute exacerbation of COPD (secondary diagnosis) were captured by International Classification of Diseases-Ninth Revision (ICD-9) codes. The hospital outcomes and length of stay were determined. Multivariate logistic regression was used to identify the independent predictors of inpatient mortality. Overall acute exacerbation of COPD-related hospitalizations accounted for nearly 3.31% of all hospitalizations in the year 2002. This did not change significantly to year 2010 (3.43%, p = 0.608). However, there was an increase in hospitalization with secondary diagnosis of COPD. Elderly white patients accounted for most of the hospitalizations. Medicare was the primary payer source for most of the hospitalizations (73-75%). There was a significant decrease in inpatient mortality from 4.8% in 2002 to 3.9% in 2010 (slope -0.096, p < 0.001). Similarly, there was a significant decrease in average length of stay from 6.4 days in 2002 to 6.0 days in 2010 (slope -0.042, p < 0.001). Despite this, the hospitalization cost was increased substantially from $22,187 in 2002 to $38,455 in 2010. However, financial burden has increased over the years.

Keywords: COPD; NIS data; hospitalization costs; mortality.

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Conflict of interest statement

Declaration of Interest statement

None of the authors have any conflicts with the contents and the results of this paper.

Figures

FIGURE 1
FIGURE 1
COPD related hospitalizations over the years. (A) Number of hospitalizations per year (B) Hospitalization rate per 10,000 US population
FIGURE 2
FIGURE 2
Additional cost of hospitalization over the years with year 2002 as reference (charges adjusted for medical care inflation)
FIGURE 3
FIGURE 3
Trends in inpatient mortality
See this image and copyright information in PMC

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