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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Article Info
Publication History
Published online: May 20, 2013
Footnotes
Funding: This work was supported by the National Institutes of Health ( K08 AG31583 , U54RR026141 , K05-CA134923 , UL1 RR029876 , 5P30AG024832 , K23AG038476 , and R01-AG033134 ) and by the Agency for Healthcare Research and Quality R01-HS020642 .
Conflicts of Interest: None.
Authorship: JB contributed to conception, design, analysis, and interpretation of data, drafting the article, and final approval of the draft. YW contributed to analysis and interpretation of data, drafting the article, and final approval of the draft. HMH contributed to conception, design, interpretation of data, drafting the article, and final approval of draft. YFK contributed to conception, design, analysis, and interpretation of data, drafting the article, and final approval of draft. GS contributed to conception, design, analysis, and interpretation of data, drafting the article, and final approval of draft.
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Copyright
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
