Table 4.
Health care resource utilization by exacerbation frequency
| Outcome | Zero exacerbation (n=29,222) |
One exacerbation (n=13,797) |
Two exacerbations (n=4,982) |
≥Three exacerbations (n=4,458) |
Total (n=52,459) |
P-valuea |
|---|---|---|---|---|---|---|
| All-cause HCRU | ||||||
| All-cause ER visits | ||||||
| Patients with one or more visits, n (%) | 11,923 (40.8) | 6,449 (46.7) | 2,674 (53.7) | 2,634 (59.1) | 23,680 (45.1) | <0.001 |
| Number of visits per patient, mean (SD) | 1.09 (2.6) | 1.28 (2.6) | 1.62 (3.0) | 2.15 (4.5) | 1.28 (2.9) | <0.001 |
| All-cause hospitalizations | ||||||
| Patients with one or more visits, n (%) | 14,519 (49.7) | 9,161 (66.4) | 3,472 (69.7) | 3,469 (77.8) | 30,621 (58.4) | <0.001 |
| Number of HOSP per patient, mean (SD) | 1.13 (2.1) | 1.65 (2.4) | 2.08 (3.0) | 2.96 (4.0) | 1.51 (2.6) | <0.001 |
| All-cause 30-day rehospitalizations | ||||||
| Patients with one or more visits, n (%) | 3,495 (12.0) | 2,604 (18.9) | 1,096 (22.0) | 1,376 (30.9) | 8,571 (16.3) | <0.001 |
| Number of HOSP per patient, mean (SD) | 0.25 (1.1) | 0.40 (1.4) | 0.52 (1.8) | 0.85 (2.7) | 0.36 (1.5) | <0.001 |
| All-cause outpatient visits | ||||||
| Patients with one or more visits, n (%) | 29,162 (99.8) | 13,779 (99.9) | 4,982 (100.0) | 4,457 (100.0) | 52,380 (99.8) | <0.001 |
| Number of visits per patient, mean (SD) | 49.24 (34.0) | 52.59 (34.8) | 57.17 (37.2) | 62.40 (39.0) | 51.99 (35.2) | <0.001 |
| COPD-related HCRU | ||||||
| COPD-related ER visits | ||||||
| Patients with one or more visits, n (%) | 120 (0.4) | 442 (3.2) | 345 (6.9) | 536 (12.0) | 1,443 (2.8) | <0.001 |
| Number of visits per patient, mean (SD) | 0.01 (0.1) | 0.04 (0.3) | 0.09 (0.4) | 0.18 (0.6) | 0.04 (0.3) | <0.001 |
| COPD-related hospitalizations | ||||||
| Patients with one or more visits, n (%) | 0 | 5,575 (40.4) | 2,396 (48.1) | 2,698 (60.5) | 10,669 (20.3) | <0.001 |
| Number of HOSP per patient, mean (SD) | 0.00 (0.0) | 0.42 (0.5) | 0.71 (0.9) | 1.38 (1.7) | 0.30 (0.8) | <0.001 |
| COPD-related 30-day rehospitalizations | ||||||
| Patients with one or more visits, n (%) | 0 | 233 (1.7) | 218 (4.4) | 500 (11.2) | 951 (1.8) | <0.001 |
| Number of HOSP per patient, mean (SD) | 0.00 (0.0) | 0.02 (0.2) | 0.05 (0.3) | 0.17 (0.7) | 0.03 (0.2) | <0.001 |
| COPD-related outpatient visits | ||||||
| Patients with one or more visits, n (%) | 16,303 (55.8) | 11,019 (79.9) | 4,685 (94.0) | 4,384 (98.3) | 36,391 (69.4) | <0.001 |
| Number of visits per patient, mean (SD) | 1.69 (2.5) | 3.17 (3.5) | 5.30 (4.3) | 9.78 (6.8) | 3.11 (4.2) | <0.001 |
| Respiratory antibiotics use | ||||||
| Patients with one or more Rx, n (%) | 19,458 (66.6) | 12,298 (89.1) | 4,795 (96.2) | 4,382 (98.3) | 40,933 (78.0) | <0.001 |
| Number of Rxs per patient, mean (SD) | 2.26 (3.1) | 3.66 (4.8) | 5.36 (4.5) | 8.48 (6.4) | 3.45 (4.5) | <0.001 |
| Oral corticosteroid use | ||||||
| Patients with one or more Rx, n (%) | 13,068 (44.7) | 9,078 (65.8) | 4,192 (84.1) | 4,177 (93.7) | 30,515 (58.2) | <0.001 |
| Number of Rxs per patient, mean (SD) | 1.44 (3.1) | 2.46 (3.9) | 4.21 (5.4) | 8.38 (7.7) | 2.56 (4.6) | <0.001 |
Note:
a
Univariate statistical comparisons were made among the four cohorts (zero, one, two, and ≥three exacerbations) using analysis of variance for continuous variables and chi-square tests for categorical variables.
Abbreviations: COPD, chronic obstructive pulmonary disease; HCRU, health care resource utilization; HOSP, hospitalizations; Rx, prescription claim; SD, standard deviation; ER, emergency room.