Research Activities, February 2014
Hospitalization rates for chronic obstructive pulmonary disease declined between 1999 and 2006
Chronic obstructive pulmonary disease (COPD) accounts for one fifth of all hospitalizations in individuals over 75 years of age, and is the third most common cause of early readmission among the elderly. Over the last 15 years, numerous advances have been made in the pharmacologic treatment and overall management of COPD. A new study suggests that these new approaches may have improved outcomes for patients with COPD.
The study of over 400,000 Medicare beneficiaries diagnosed with COPD between 1999 and 2006 found that the hospitalization rate decreased by 18 percent for all causes, by 24 percent for all respiratory causes, and by 14 percent for all nonrespiratory causes. Likewise, the number of patients who experienced 2 or more acute COPD exacerbations decreased by 23 percent over the 10-year study period.
A number of factors may have contributed to reduced hospitalizations for all respiratory causes. First, the use of long-acting beta agonists with corticosteroids, which increased after the release of combination long-acting beta agonists and corticosteroids in 2000, and the release of Global Initiatives for Chronic Obstructive Lung Disease guidelines in 2001 may have helped reduce the rate of acute exacerbations of COPD. Second, an increase in the influenza vaccination rate among older adults in the United States may have contributed to reduced morbidity. Other factors include a decline in the adult smoking rate, reduced exposure to second-hand smoke and other environmental exposures, and improved access to screening and other preventive services. This study was supported in part by AHRQ (HS20642).
See "Temporal trends in hospitalization rates for older adults with chronic obstructive pulmonary disease," by Jacques Baillargeon, Ph.D., Yue Wang, M.S., Yong-Fang Kuo, Ph.D., and others in American Journal of Medicine 126, pp. 607-614, 2013.