Health care costs increase as COPD exacerbations spike during colder months
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NEW ORLEANS — An uptick in hospitalizations and deaths related to COPD exacerbations during the coldest months of the year — January, February and March — places a significant burden on health care resources, researchers reported at the CHEST Annual Meeting.
Abhishek Chakraborti, MD, from Brookdale Hospital and Medical Center in Brooklyn, New York, and colleagues conducted a retrospective analysis of data from the 2016 National Inpatient Sample and National Inpatient Database on 530,229 patients (mean age, 68 years; 58% women) with a principal diagnosis of acute COPD exacerbation to identify seasonal variations in outcomes for COPD admissions and their impact on health care resource utilization.
For the analysis, the primary outcome was 30-day all-cause readmission and the year was divided into quarters: January, February and March; April, May and June; July, August and September; and October, November and December.
Approximately one-third of hospital admissions for COPD exacerbations occurred during the first quarter, with results showing that patients admitted during the first quarter also had the highest rates of readmission when compared with the second (adjusted OR = 0.93; P < .01) and fourth quarters (aOR = 0.95; P < .01). Mortality was also higher among patients admitted during the first quarter, as compared with the second (aOR = 0.84; P < .01), third (aOR = 0.78; P < .01) and fourth quarters (aOR = 0.84; P < .01).
“The higher rates of COPD admissions during colder months is a phenomenon that remains poorly understood. There is evidence to suggest respiratory tract viral infections, such as rhinovirus, respiratory syncytial virus and adenoviruses, follow a seasonal pattern in temperate climates, which in turn lead to COPD exacerbations. Lower humidity, higher air pollution levels and declining lung function in colder temperatures are all possible factors that need to be taken into consideration and require further research,” Chakraborti told Healio Pulmonology.
Additionally, during the first quarter, patients had a longer length of hospital stay than during the second (adjusted mean difference, –0.13 days; P < .01), third (adjusted mean difference, –0.22 days; P < .01) and fourth quarters (adjusted mean difference, –0.13 days; P < .01).
Although total hospitalization costs were similar for the first, second and third quarters, costs were higher in the fourth quarter (adjusted mean difference, $163.3; P < .05). Hospitalization charges, however, were higher in the first quarter when compared with the second (adjusted mean difference, –$590.77; P < .01) and third quarters (adjusted mean difference, –$873.67; P < .01).
“The financial burden following the same seasonal pattern as COPD exacerbations is particularly interesting to note. This could possibly be attributed to patients admitted during the first quarter of the year requiring more intensive treatment, such as mechanical ventilation, bronchoscopy and higher drug utilization,” Chakraborti said. “Given the projected exponential increase in the financial burden of COPD, an effort to redistribute health care resources to target months of higher demand would be a prudent, cost-saving measure. Intensifying preventive measures in the first quarter of the year needs to be looked into as well, as it could ultimately reduce the number of people requiring hospital admissions and impact overall mortality and morbidity.” – by Melissa Foster
Reference:
Chakraborti A, et al. Tuesday Electronic Posters 4. Presented at: CHEST Annual Meeting; Oct. 19-23, 2019; New Orleans.
For more information:
Abhishek Chakraborti, MD, can be reached at abhishek_c@outlook.com; Twitter: @achakrab14.
Disclosure: Chakraborti reports no relevant financial disclosures.