OBJECTIVES
• To assess the percentage of patients with newly diagnosed COPD who had received spirometry testing around the time of their initial COPD diagnosis in 2011.
• To assess the percentage of patients experiencing COPD-related hospitalizations and 30-day readmissions in 2011.
METHODS
Study Design
• Retrospective cohort study using a nationally representative administrative claims database from 2007 to 2011.
• RTI International’s institutional review board determined that this study met all criteria for exemption.
Data Source: PharMetrics Plus Database
• Commercially available source of computerized administrative claims information covering more than 150 million lives across the US.
• Information includes demographics, health plan enrollment, diagnoses, dates and place of service, diagnostic testing, procedures, inpatient and outpatient physician services, and prescription drug use.
• Data are tracked longitudinally for enrollees via deidentifi ed and unique identifi cation numbers.
RESULTS
• Demographic and clinical characteristics for both study
cohorts are shown in Table 1. Spirometry Testing Cohort
• 94,778 patients met all criteria for the spirometry testing cohort and were included in the overall COPD study population.
• Overall, 37.6% of the patients with newly diagnosed COPD in 2011 had evidence of spirometry testing in the 24 months before or 6 months after the index date.
• The percentage of patients with spirometry testing was highest in the Northeast (40.3%), followed by the Midwest (37.7%) and the South (37.4%), and lowest in the West (31.6%).
• The percentage of patients receiving spirometry testing varied by state, with the lowest percentage in Wyoming (24.6%) and the highest percentage in Rhode Island (61.2%).
Inpatient Readmission Cohort
• 49,986 patients met all the criteria for the inpatient
readmission cohort and were included in this portion of the analysis.
• Overall, 7.1% (n = 3,564) of the patients with a COPD-related hospitalization had a COPD-related readmission within 30 days of discharge from the fi rst COPD-related hospitalization in 2011.
• The percentage of patients with a 30-day COPD-related readmission was highest in the Northeast (7.9%), followed by the Midwest (7.4%) and the West (7.1%), and lowest in the South (6.3%).
• The 30-day COPD-related readmission rates varied by state, from 2.0% of patients in South Dakota to 20.8% of patients in the District of Columbia (Figure 2).
CONCLUSIONS
• Despite clinical guidelines recommending
spirometry testing to confi rm COPD diagnosis,12 a
high percentage of patients newly diagnosed with
COPD (62.4%) did not have evidence of spirometry
testing in the 24 months before or 6 months after
their fi rst COPD diagnosis.
• Consistent with previous fi ndings,8,9 in this study,
COPD-related 30-day readmissions were present in
approximately 7% of the hospitalized COPD population in 2011.
• There is a substantial variation in these rates across
the US at the state level.