Costs, Medical Services Use High for Pulmonary Patients

Use of spirometry to diagnose chronic obstructive pulmonary disease varies by region

WEDNESDAY, July 16 (HealthDay News) -- Patients with chronic obstructive pulmonary disease (COPD) alone or with asthma use more medical services and incur higher costs than patients with asthma alone, according to the results of a study in the July issue of Chest. A related study in the same issue found that the use of spirometry to diagnose COPD varies greatly among regions in the United States.

Fadia T. Shaya, Ph.D., from the University of Maryland in Baltimore, and colleagues examined the use of medical services for 3,072 asthma patients, 3,455 COPD patients, and 2,604 patients with both conditions, where all patients were 40 to 64 years old and received Medicaid insurance. They found that patients with both COPD and asthma used the most services. Patients with COPD alone or with asthma were more likely to use physician and inpatient services, were less likely to use outpatient services, and incurred more costs for total medical services than patients with asthma alone.

In the second study, Min J. Joo, M.D., and colleagues from Hines VA Hospital in Hines, Ill., assessed regional patterns of spirometry use in diagnosing COPD among 93,724 veterans over 42 years old, where spirometry use occurred 760 days prior to diagnosis or 180 days after diagnosis. They found that 36.7 percent of patients underwent spirometry, with a more than threefold variation in usage likelihood among regions (adjusted odds ratio varying from 0.52 to 1.61 for lowest versus highest use regions).

"Overall, the use of spirometry in patients with newly diagnosed COPD was low using the new HEDIS spirometry measure with a significant regional variation comprising a more than threefold difference between the regions with the lowest and highest rates of spirometry use," the authors conclude.

The first study was funded by GlaxoSmithKline.

Abstract - Shaya
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Abstract - Joo
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