Chest
Original Research: COPD FeaturedHospital Discharges, Readmissions, and ED Visits for COPD or Bronchiectasis Among US Adults
Section snippets
Materials and Methods
The Healthcare Cost and Utilization Project (HCUP) comprises a series of national and state-level databases.3 This study used data from the Nationwide Inpatient Sample (NIS) and the Nationwide Emergency Department Sample (NEDS) database. This study was exempt from institutional review.
The NIS is created by drawing a stratified probability sample of hospitals drawn from State Inpatient Databases that include hospitalizations by patients with Medicare, Medicaid, private insurance, and the
Results
The weighted number of hospital discharges for COPD and bronchiectasis ranged from 534,398 to 692,364 (Fig 1). Of the numbers of combined COPD and bronchiectasis hospitalizations, 98.1% to 98.6% were for COPD (ICD-9 codes 490, 491, 492, 496). The average annual number of discharges was about 100,000 higher from 2008 to 2012 than from 2001 to 2007. The age-adjusted rate of discharges ranged from 242.7 to 286.0 per 100,000 population and showed no clear trend (Ptrend = .554) (Table 1).
Discussion
The current study, which provides the most up-to-date statistics, shows no significant trend in the age-adjusted rates of hospital discharges from 2001 to 2012 or ED visits from 2006 to 2011 for COPD or bronchiectasis. The persistence of these rates in the face of large declines in the prevalence of smoking is a bit perplexing but underscores the protracted nature of COPD. Significantly decreasing trends were found for mean length of stay and for the in-hospital case-fatality rate.
The lack of
Acknowledgments
Author contributions:E. S. F. had full access to all of the data in the study, takes responsibility for the integrity of the data and the accuracy of the analysis, and is responsible for the study concept and design, data acquisition, analysis, and interpretation, and manuscript preparation.
Financial/nonfinancial disclosures:The author has reported toCHESTthat no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.
References (34)
- et al.
COPD surveillance—United States, 1999-2011
Chest
(2013) - et al.
Total and state-specific medical and absenteeism costs of COPD among adults aged ≥18 years in the United States for 2010 and projections through 2020
Chest
(2015) - et al.
Temporal trends in chronic obstructive lung disease case fatality in hospitalized US veterans: 1970-1987
Chest
(1991) - et al.
Trends in the prevalence of obstructive and restrictive lung function among adults in the United States: findings from the National Health and Nutrition Examination surveys from 1988-1994 to 2007-2010
Chest
(2013) - et al.
Transitional care management reimbursement to reduce COPD readmission
Chest
(2014) - et al.
Positive predictive value of ICD-9-CM codes to detect acute exacerbation of COPD in the emergency department
Jt Comm J Qual Patient Saf
(2008) Overview of the Nationwide Emergency Department Sample (NEDS). Healthcare Cost and Utilization Project (HCUP) website
Introduction to the HCUP Nationwide Emergency Department Sample (NEDS) 2011. Healthcare Cost and Utilization Project (HCUP) website
Welcome to HCUPnet. Healthcare Cost and Utilization Project (HCUP) website
Mortality trends during a program that publicly reported hospital performance
Med Care
Our nation's air - status and trends through 2008. US Environmental Protection Agency website
Chronic obstructive pulmonary disease among adults—United States, 2011
MMWR Morb Mortal Wkly Rep
Rehospitalizations among patients in the Medicare fee-for-service program
N Engl J Med
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FOR EDITORIAL COMMENT SEE PAGEFUNDING/SUPPORT:The author has reported toCHESTthat no funding was received for this study.Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.