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Contributions of COPD, asthma, and ten comorbid conditions to health care utilization and patient-centered outcomes among US adults with obstructive airway disease.
Int J Chron Obstruct Pulmon Dis. 2017; 12:2515-2522.IJ

Abstract

BACKGROUND

Among persons with obstructive airway disease, the relative contributions of chronic obstructive pulmonary disease (COPD), asthma, and common comorbid conditions to health care utilization and patient-centered outcomes (PCOs) have not been previously reported.

METHODS

We followed a total of 3,486 persons aged ≥40 years with COPD, asthma, or both at baseline, from the Medical Expenditure Panel Survey (MEPS) cohorts enrolled annually from 2008 through 2012 for 1 year. MEPS is a prospective observational study of US households recording self-reported COPD, asthma, and ten medical conditions: angina, arthritis, cancer, coronary heart disease, cognitive impairment, diabetes, hypertension, lung cancer, myocardial infarction, and stroke/transient ischemic attack. We studied the separate contributions of these conditions to health care utilization (all-cause and respiratory disease hospitalization, any emergency department [ED] visit, and six or more outpatient visits) and PCOs (seven or more days spent in bed due to illness, incident loss of mobility, and incident decline in self-perceived health).

RESULTS

COPD made the largest contributions to all-cause and respiratory disease hospitalization and ED visits, while arthritis made the largest contribution to outpatient health care. Arthritis and COPD, respectively, made the greatest contributions to the PCOs.

CONCLUSION

COPD made the largest and second largest contributions to health care utilization and PCOs among US adults with obstructive airway disease. The twelve medical conditions collectively accounted for between 52% and 61% of the health care utilization outcomes and between 53% and 68% of the PCOs. Cognitive impairment, diabetes, hypertension, and stroke also made significant contributions.

Authors+Show Affiliations

Department of Internal Medicine, Section of Geriatrics, Yale University School of Medicine, New Haven, CT, USA.Department of Internal Medicine, Section of Geriatrics, Yale University School of Medicine, New Haven, CT, USA.Department of Internal Medicine, Section of Geriatrics, Yale University School of Medicine, New Haven, CT, USA.Department of Internal Medicine, Section of Thoracic Medicine, Geisinger Medical Center, Danville, PA, USA.Department of Internal Medicine, Section of Thoracic Medicine, Geisinger Medical Center, Danville, PA, USA.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

28883718

Citation

Murphy, Terrence E., et al. "Contributions of COPD, Asthma, and Ten Comorbid Conditions to Health Care Utilization and Patient-centered Outcomes Among US Adults With Obstructive Airway Disease." International Journal of Chronic Obstructive Pulmonary Disease, vol. 12, 2017, pp. 2515-2522.
Murphy TE, McAvay GJ, Allore HG, et al. Contributions of COPD, asthma, and ten comorbid conditions to health care utilization and patient-centered outcomes among US adults with obstructive airway disease. Int J Chron Obstruct Pulmon Dis. 2017;12:2515-2522.
Murphy, T. E., McAvay, G. J., Allore, H. G., Stamm, J. A., & Simonelli, P. F. (2017). Contributions of COPD, asthma, and ten comorbid conditions to health care utilization and patient-centered outcomes among US adults with obstructive airway disease. International Journal of Chronic Obstructive Pulmonary Disease, 12, 2515-2522. https://doi.org/10.2147/COPD.S139948
Murphy TE, et al. Contributions of COPD, Asthma, and Ten Comorbid Conditions to Health Care Utilization and Patient-centered Outcomes Among US Adults With Obstructive Airway Disease. Int J Chron Obstruct Pulmon Dis. 2017;12:2515-2522. PubMed PMID: 28883718.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Contributions of COPD, asthma, and ten comorbid conditions to health care utilization and patient-centered outcomes among US adults with obstructive airway disease. AU - Murphy,Terrence E, AU - McAvay,Gail J, AU - Allore,Heather G, AU - Stamm,Jason A, AU - Simonelli,Paul F, Y1 - 2017/08/23/ PY - 2017/9/9/entrez PY - 2017/9/9/pubmed PY - 2018/6/5/medline KW - AAF KW - COPD KW - average attributable fraction KW - chronic obstructive pulmonary disease KW - health care utilization KW - patient-centered outcomes SP - 2515 EP - 2522 JF - International journal of chronic obstructive pulmonary disease JO - Int J Chron Obstruct Pulmon Dis VL - 12 N2 - BACKGROUND: Among persons with obstructive airway disease, the relative contributions of chronic obstructive pulmonary disease (COPD), asthma, and common comorbid conditions to health care utilization and patient-centered outcomes (PCOs) have not been previously reported. METHODS: We followed a total of 3,486 persons aged ≥40 years with COPD, asthma, or both at baseline, from the Medical Expenditure Panel Survey (MEPS) cohorts enrolled annually from 2008 through 2012 for 1 year. MEPS is a prospective observational study of US households recording self-reported COPD, asthma, and ten medical conditions: angina, arthritis, cancer, coronary heart disease, cognitive impairment, diabetes, hypertension, lung cancer, myocardial infarction, and stroke/transient ischemic attack. We studied the separate contributions of these conditions to health care utilization (all-cause and respiratory disease hospitalization, any emergency department [ED] visit, and six or more outpatient visits) and PCOs (seven or more days spent in bed due to illness, incident loss of mobility, and incident decline in self-perceived health). RESULTS: COPD made the largest contributions to all-cause and respiratory disease hospitalization and ED visits, while arthritis made the largest contribution to outpatient health care. Arthritis and COPD, respectively, made the greatest contributions to the PCOs. CONCLUSION: COPD made the largest and second largest contributions to health care utilization and PCOs among US adults with obstructive airway disease. The twelve medical conditions collectively accounted for between 52% and 61% of the health care utilization outcomes and between 53% and 68% of the PCOs. Cognitive impairment, diabetes, hypertension, and stroke also made significant contributions. SN - 1178-2005 UR - https://www.unboundmedicine.com/medline/citation/28883718/Contributions_of_COPD_asthma_and_ten_comorbid_conditions_to_health_care_utilization_and_patient_centered_outcomes_among_US_adults_with_obstructive_airway_disease_ L2 - https://dx.doi.org/10.2147/COPD.S139948 DB - PRIME DP - Unbound Medicine ER -