Hospitalizations for Acute Exacerbations of Chronic Obstructive Pulmonary Disease: How You Count Matters

被引:35
作者
Stein, Brian D. [2 ]
Charbeneau, Jeffery T. [1 ]
Lee, Todd A. [3 ,4 ]
Schumock, Glen T. [3 ]
Lindenauer, Peter K. [5 ]
Bautista, Adriana [3 ]
Lauderdale, Diane S. [1 ]
Naureckas, Edward T. [6 ]
Krishnan, Jerry A. [1 ,6 ]
机构
[1] Univ Chicago, Dept Hlth Studies, Chicago, IL 60637 USA
[2] Rush Univ, Med Ctr, Pulm & Crit Care Med Sect, Chicago, IL 60612 USA
[3] Univ Illinois, Ctr Pharmacoecon Res, Chicago, IL USA
[4] Hines VA Hosp, Ctr Management Complex Chron Care, Hines, IL USA
[5] Baystate Med Ctr, Ctr Qual Care Res, Springfield, MA USA
[6] Univ Chicago, Pulm & Crit Care Med Sect, Chicago, IL 60637 USA
基金
美国国家卫生研究院;
关键词
UNITED-STATES; MORTALITY; ACCURACY; DEATH; RISK; COPD; COMORBIDITIES; DIAGNOSIS; ICD-9-CM; CARE;
D O I
10.3109/15412555.2010.481696
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
ICD-9-CM diagnosis codes are increasingly used to estimate the burden of disease, as well as to evaluate the quality of care and outcomes of various conditions. Acute exacerbations of COPD (AE-COPD) are common and associated with substantial health and financial burden in the U.S. Whether published algorithms that employ different combinations of ICD-9-CM codes to identify patients hospitalized for AE-COPD yield similar or different estimates of disease burden is unclear. In this study, the Nationwide Inpatient Sample from years 2000-2006 was used to identify and compare the number of hospitalizations, healthcare utilization, and outcomes for patients hospitalized for AE-COPD in the U.S. AE-COPD was identified using five different published ICD-9-CM algorithms. Estimates of the annual number of hospitalizations for AECOPD in the U.S. varied more than 2-fold (e.g., 421,000 to 870,000 in 2006). Outcomes and healthcare utilization of patients hospitalized for AE-COPD varied substantially, depending on the algorithm used (e.g., in-hospital mortality 2.0% to 5.1%, total hospital days 2.0 to 5.1 million in 2006). Observed trends in the number of hospitalizations over the 7-year period varied depending on which algorithm was used. In conclusion, the estimated health burden and trends in hospitalizations for AE-COPD in the United States differ, depending on which ICD-9-CM algorithm is used. To improve our understanding of the burden of AE-COPD and to ensure that quality of care initiatives are not misdirected, a validated approach to identifying patients hospitalized for AE-COPD is needed.
引用
收藏
页码:164 / 171
页数:8
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