Contributions of COPD, asthma, and ten comorbid conditions to health care utilization and patient-centered outcomes among US adults with obstructive airway disease

• Published in: International journal of chronic obstructive pulmonary disease 2017-01, Vol.12, p.2515-2522
• Main Authors: Murphy, Terrence E, McAvay, Gail J, Allore, Heather G, Stamm, Jason A, Simonelli, Paul F
• Format: Article
• Language: English
• Subjects: Adult; Aged; Ambulatory Care; Asthma; Asthma - diagnosis; Asthma - economics; Asthma - epidemiology; Asthma - therapy; average attributable fraction (AAF); Cardiovascular disease; Care and treatment; Chronic obstructive lung disease; Chronic obstructive pulmonary disease; chronic obstructive pulmonary disease (COPD); Comorbidity; Demographic aspects; Diabetes; Diagnosis; Emergency Service, Hospital; Ethnicity; Female; Health Care Costs; Health Care Surveys; Health Expenditures; Health Resources - economics; Health Resources - utilization; Health services utilization; Health Status; healthcare utilization; Hospitalization; Humans; Male; Medical care utilization; Middle Aged; Mobility; Mortality; Original Research; Patient outcomes; Patient-Centered Care - economics; patient-centered outcomes; Patients; Population; Prospective Studies; Pulmonary Disease, Chronic Obstructive - diagnosis; Pulmonary Disease, Chronic Obstructive - economics; Pulmonary Disease, Chronic Obstructive - epidemiology; Pulmonary Disease, Chronic Obstructive - therapy; Risk Factors; Sociodemographics; Time Factors; Treatment Outcome; United States - epidemiology
• ISSN: 1178-2005; 1176-9106; 1178-2005
• DOI: 10.2147/COPD.S139948

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. 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). 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. 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.