Predictors of higher cost include older age, male sex, and hospital location.
Researchers examined records to explore the incidence of emergency department (ED) visits and subsequent hospitalizations related to chronic obstructive pulmonary disease (COPD) and found that the costs are “significant and increasing.”
The results of the study were published in Respiratory Research on January 6, 2015. Jasvinder A. Singh, of the Medicine Service at the Birmingham VA Medical Center in Birmingham, AL, and colleagues used data from the 2009-12 Nationwide Emergency Department Sample (NEDS) to learn more about the issue.
COPD is the third leading cause of mortality in the United States, and “poses a high societal economic burden” as well as decreasing the quality of life in those diagnosed with the disease. The researchers set out to “examine the predictors and estimates of ED and inpatient utilization due to COPD as the primary diagnosis and post-hospitalization dispostion, using contemporary NEDS data.”
They specifically looked at how patients were discharged, the ED charges, whether patients were discharged to home or somewhere else, the length of hospital stays, and the total charge including ED and inpatient costs. They found that the number of ED visits due to COPD “increased from 1.02 million in 2009 to 1.04 in 2010 to 1.10 in 2012, marking a steady rise.
Using the data from 2012, the study reports that the mean age of the patients who went to the ED due to COPD was 65.5 years, 55% were female, and Medicare was the primary payer for 63% of them. The south represented 45% of all visits, as well as an overall lower income.
There were several predictors of higher charges, including, “older age, male sex, residence in metropolitan area and hospital location in the Midwest, South or West US location.”
Most (65.4%) patients with COPD who visited the ED were discharged to home.
“Older age, metropolitan residence and comorbidities” were all associated with a greater risk of being hospitalized and less chance of being discharged to home. Another factor that increased the risk of hospitalization was higher income. The researchers suggest that future studies should “examine whether interventions targeting these modifiable factors can improve COPD outcomes.”