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Temporal Trends in Hospitalization Rates for Older Adults with Chronic Obstructive Pulmonary Disease

  • Jacques Baillargeon
    Correspondence
    Requests for reprints should be addressed to Jacques Baillargeon, PhD, Department of Preventive Medicine and Community Health, University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555.
    Affiliations
    Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston

    Sealy Center on Aging, University of Texas Medical Branch, Galveston
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  • Yue Wang
    Affiliations
    Sealy Center on Aging, University of Texas Medical Branch, Galveston

    Department of Internal Medicine, University of Texas Medical Branch, Galveston
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  • Yong-Fang Kuo
    Affiliations
    Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston

    Sealy Center on Aging, University of Texas Medical Branch, Galveston

    Department of Internal Medicine, University of Texas Medical Branch, Galveston
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  • Holly M. Holmes
    Affiliations
    Department of General Internal Medicine, University of Texas, M.D. Anderson Cancer Center, Houston
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  • Gulshan Sharma
    Affiliations
    Sealy Center on Aging, University of Texas Medical Branch, Galveston

    Department of Internal Medicine, University of Texas Medical Branch, Galveston
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      Abstract

      Background

      Over the last 15 years, substantial advances have been made in the treatment of chronic obstructive pulmonary disease (COPD). Little information is available, however, on whether these treatments have resulted in reduced rates of hospitalization and acute exacerbations among COPD patients. This retrospective cohort study examined changes in hospitalization rates among Medicare beneficiaries with COPD from 1999 to 2008.

      Methods

      We analyzed data from 424,418 fee-for-service Medicare beneficiaries enrolled between 1999 and 2008 who were diagnosed with COPD. We examined temporal changes in the frequency of hospitalization and acute exacerbations among Medicare beneficiaries with COPD.

      Results

      Over the 10-year study period, the hospitalization rates for COPD patients—adjusted for age, sex, race, socioeconomic status, region, and number of comorbidities—decreased: from 131 to 107 per 100 person-years for all causes (P <.001); from 58 to 44 per 100 person-years for all respiratory causes (P <.001); and from 73 to 63 per 100 person-years for nonrespiratory causes (P <.001). There was no change in prevalence of COPD in the Medicare population over this time. Additionally, the percentage of COPD patients hospitalized with 2 or more acute exacerbations decreased from 5.5% to 4.3% over the 10-year study period (P <.001).

      Conclusion

      Between 1999 and 2008, hospitalization rates decreased substantially among Medicare beneficiaries diagnosed with COPD.

      Keywords

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