-
International Journal of Chronic Obstructive Pulmonary Disease
- About Dovepress
Open access peer-reviewed scientific and medical journals.
- Open Access
Dove Medical Press is now a member of the Open Access Initiative
- An Author's Guide
A guide to help authors get their paper published.
- Advocacy
Support Open Access and Dove Press
- Reprints
Promotional Article Monitoring - further details
- Favored Author Program
Real benefits for authors, including fast-track processing of papers.
Geographic disparities in chronic obstructive pulmonary disease (COPD) hospitalization among Medicare beneficiaries in the United States
Original Research
(5220) Total Article Views
Authors: Holt JB, Zhang X, Presley-Cantrell L, Croft JB
Published Date June 2011 Volume 2011:6 Pages 321 - 328
DOI: http://dx.doi.org/10.2147/COPD.S19945
James B Holt, Xingyou Zhang, Letitia Presley-Cantrell, Janet B CroftNational Center for Chronic Disease Prevention and Health Promotion, US Centers for Disease Control and Prevention, Atlanta, GA, USA
Background: Hospitalizations for persons with chronic obstructive pulmonary disease (COPD) result in significant health care resource use and excess expenditures. Despite well-documented sociodemographic disparities in COPD outcomes, no study has characterized geographic variations in COPD hospitalization across the US.
Methods: Almost 3.8 million COPD hospitalization records were extracted from Medicare claims for 1995–2006, and the total population of eligible Medicare beneficiaries was extracted from the Medicare enrollment records to calculate COPD hospitalization rates by Health Service Area (HSA), (n = 949). Spatial cluster analysis and Bayesian hierarchical spatial modeling were used to characterize the geography of COPD hospitalizations.
Results: The overall COPD hospitalization rate was 11.30 per 1,000 beneficiaries for the aggregated period 1995–2006. HSA-level COPD hospitalization rates had a median of 11.7 and a range of 3.0 (Cache, UT) to 76.3 (Pike, KY). Excessive hospitalization risk was concentrated in Appalachia, the southern Great Lakes, the Mississippi Delta, the Deep South, and west Texas. In the Bayesian spatial mixture model, 73% of variability of COPD hospitalization relative risk was attributed to unidentified regional social and physical environments shared by HSAs rather than to unique local HSA factors (27%).
Conclusion: We discovered distinct geographic patterns in COPD hospitalization rates and risks attributed to both regionally-shared environmental risk factors and HSA-unique environmental contexts. The correlates of these geographic patterns remain to be determined. Geographic comparisons of COPD hospitalization risk provide insights for better public health practice, policies, and programs for COPD prevention.
Keywords: COPD prevention, environmental risk factors, public health, population
Post to:
Cannotea Citeulike Del.icio.us Facebook LinkedIn Twitter
Readers of this article also read:
- Journal Indexing
See where all the Dove Press journals are indexed.
- Testimonials
"You do a tremendous job!!" Ruben Restrepo, University of Texas Health Science Center, San Antonio.
- Clinical effectiveness of the Respimat® inhaler device in managing chronic obstructive pulmonary disease: evidence when compared with other handheld inhaler devices
- Chronic obstructive pulmonary disease as an independent risk factor for cardiovascular morbidity
- The pathophysiology of bronchiectasis
- Exacerbation rate, health status and mortality in COPD – a review of potential interventions