Hospital discharges, readmissions, and ED visits for COPD or bronchiectasis among US adults: findings from the nationwide inpatient sample 2001-2012 and Nationwide Emergency Department Sample 2006-2011

Abstract

Background: Numbers and rates of hospitalizations and ED visits by patients with COPD are important metrics for surveillance purposes. The objective of this study was to examine trends in these rates from 2001 to 2012 among adults aged ≥ 18 years in the United States.

Methods: Data from the Nationwide Inpatient Sample (NIS) and Nationwide Emergency Department Sample (NEDS) were examined for temporal trends in the numbers and rates of hospitalizations by patients with COPD or bronchiectasis, mean length of stay, in-hospital case-fatality rate, 30-day readmission rate, and numbers and rates of ED visits.

Results: The national number of discharges with COPD or bronchiectasis as the principal diagnosis was about 88,000 higher in 2012 than in 2001, but the age-adjusted rate of discharges did not change significantly (range, 242.7-286.0 per 100,000 population, P trend = .554). In contrast, hospitalization rates for common cardiovascular disorders, pneumonia, and lung cancer decreased significantly by 27% to 68%, whereas the mean charge doubled and mean cost increased by 40%. From 2006 to 2011, the numbers of ED visits increased from 1,480,363 to 1,787,612. The age-adjusted rate increased nonsignificantly from 654 to 725 per 100,000 population (P trend = .072).

Conclusions: Despite many local and national efforts to reduce the burden of COPD, total hospitalizations and ED visits over the past decade have increased for COPD, and the age-adjusted rates of hospitalizations and ED visits for COPD or bronchiectasis have not changed significantly in the United States.

Figure 1

Numbers of hospital discharges for COPD or bronchiectasis among patients aged ≥ 18 y, Nationwide Inpatient Sample 2001-2012.

Figure 2

Age-adjusted rate of hospitalizations for selected chronic conditions among patients aged ≥ 18 y, Nationwide Inpatient Sample 2001-2012. AMI = acute myocardial infarction; B = bronchiectasis; CA = coronary atherosclerosis; CHF = congestive heart failure; OHD = other heart disease.

Figure 3

Aggregate charges for inpatient stays for COPD or bronchi-ectasis among patients aged ≥ 18 y, Nationwide Inpatient Sample 2001-2012.

Figure 4

Age-adjusted rate of ED visits for selected chronic conditions among patients aged ≥ 18 y, Nationwide Emergency Department Sample 2006-2011. See Figure 2 legend for expansion of abbreviations.