Sex Differences in Ambulatory Visits for Chronic Obstructive Pulmonary Disease, Based on the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey from 1995 to 2004

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a rapidly growing public health problem in the United States. It is unclear whether men and women differ in their utilization of ambulatory care or medications prescribed for COPD.

OBJECTIVE: To evaluate sex-related trends in physician-office and out-patient department COPD visits from 1995 through 2004.

METHODS: We pooled data from the National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS) to derive national estimates of out-patient ambulatory COPD visits. For trend analysis we stratified the data into 2-year periods and by sex. The main variables of interest were the number of out-patient visits for COPD, patient characteristics, comorbidities, and medications prescribed.

RESULTS: From 1995 to 2004, COPD-related out-patient visits increased among women and men; oral corticosteroids and short-acting bronchodilators were the most commonly prescribed drugs for both women and men; and prescriptions for inhaled corticosteroid decreased in both women (from 20% to 11%) and men (from 20 to 17%). In 2004, women surpassed men in out-patient COPD visits.

CONCLUSIONS: COPD visits increased among both sexes, but the upward trend in COPD visits among women indicates that COPD is no longer a male-dominated disease. Providers should be aware of this shift in patient demographics and the differences between the sexes in COPD management.