Trend Analysis of Chronic Obstructive Pulmonary Disease Hospitalization Rates in Texas

Background: Chronic Obstructive Pulmonary Disease (COPD) is a progressive lung disease associated with substantial morbidity and mortality. Between 1988 and 1999 the CDC MMWR reported that nationally there was an increasing trend in the overall rate of COPD hospitalizations. The highest hospitalization rates were among non-Hispanic (NH) White males. Objective: The objective of this study is to examine temporal trends of COPD hospitalization rates in Texas from 1999 to 2007. Methods: Race and gender adjusted COPD hospitalization/100,000 determined by admitting diagnosis ICD-9 codes (491, 492, 496) were collected from Texas Health Care Information Collection (THCIC) datasets from 1999 to 2007. Results: Overall, there was a decline in the rate of hospitalizations due to COPD (37.79%). Females had higher COPD hospitalization rates than males. NH White females had the highest rate of hospitalization across all years followed by NH White males. Except for 2000, NH Black females had higher hospitalization rates than Black males. Hispanics had the lowest hospitalization rates. Conclusions: COPD hospitalization rates in Texas declined over the period 1999 to 2007, in contrast to the national increase from 1988 to 1999. Moreover, females had higher hospitalization rates compared to males. A number of factors may have contributed to these trends including decline in prevalence associated with decline in smoking and other risk factors, improved access to health care, and changes in medical practice patterns and medical management.