COPD hospitalizations for elderly Medicare beneficiaries

This study examines the incidence of hospitalizations for chronic obstructive pulmonary disease (COPD) among elderly Medicare beneficiaries. COPD comprises several conditions that cause airflow obstruction and breathing problems. Acute exacerbations of COPD frequently require inpatient hospitalization, often with mechanical ventilation. Patients age 65 and older account for over 67% of U.S. COPD hospitalizations. MEDPAR inpatient hospital discharge data are examined for Medicare fee-for-service beneficiaries age 65 and over discharged during fiscal year 2005 for DRG 88 (COPD) (N=355,186). Incidence patterns and length of stay are examined by Medicare beneficiary group, age, race and sex. Source of admission, discharge destination, rehospitalizations, in-hospital and post-discharge mortality are also examined. The average patient was 74 years old. Over 57% of these patients were female. Approximately 87% of the patients were white and 8.4% were black. Nearly 73% of admissions came from the emergency room. The average length of stay for these hospitalizations was 4.9 days. The average inpatient charge was $16,519. Patients frequently required additional formal care after discharge. While 62.1% of patients were discharged to home, 34.7% were discharged to some form of post-acute care. Beneficiaries in older age groups had a higher frequency of discharge to post-acute care (most often home health care). While only 1.6% of patients died during hospitalization, 27% died within one year after discharge and 40.8% died within 2 years after discharge. Post-discharge mortality was greater among older age groups. Readmission in 2005 or 2006 for COPD or other respiratory conditions was common among these patients.