By: James Pitt  Jun. 01, 2018
Chronic obstructive pulmonary disorder (COPD) is a common lung disease, mainly caused by smoking. There is evidence that COPD patients are at greater risk of mortality when exposed to air pollution, particularly particulate matter. Dexur analysts examined 2016 CMS inpatient discharge data from 20 Oklahoma hospitals with over 1,000 discharges that year. The incidence of COPD varied dramatically across hospitals, from 5.61% of total Medicare discharges at Jackson County Memorial Hospital to 0.54% at Mercy Hospital Oklahoma City.
Though there is a well-established link between particulate matter and COPD morbidity, particulate matter levels are not the only metric of air pollution. The Environmental Protection Agency’s Air Quality Index (AQI) is a composite measure of several different air quality measures. In Oklahoma, median AQI for 2016 was uniformly good. Higher AQIs indicate worse air quality. Grady County had the best air quality in Oklahoma 2016, with a median AQI of 9. Tulsa County’s median AQI was 45 - the highest reported in Oklahoma, but still comfortably under the good-to-moderate cutoff of 50.
In this data, there was no evidence of a link between hospital-level COPD incidence and county-level AQI. This should not be taken to mean there is no such link. The low variation in air quality across counties, and number of counties with no air quality index report, provide little power to detect an effect.
Eastar Health System Main (Muskogee, OK), which became Saint Francis Health System in April 2017, is an interesting case. This hospital had high COPD incidence in a particularly low-pollution county. The reported coordinates of Muskogee’s air quality monitoring station are closer to OGE Muskogee Power Plant than Eastar Health System Main is. It is therefore likely that this hospital serves a population with some other cause of vulnerability to COPD.
Hospitals mentioned in this article:
For all patients discharged with chronic obstructive pulmonary disease in 2016, at Integris Baptist Medical Center (Oklahoma City, OK),St Anthony Hospital (Oklahoma City, OK),Oklahoma University Medical Center (Oklahoma City, OK),Mercy Hospital Oklahoma City (Oklahoma City, OK),Integris Southwest Medical Center (Oklahoma City, OK),Eastar Health System Main (Muskogee, OK),Oklahoma Heart Hospital (Oklahoma City, OK),Comanche County Memorial Hospital (Lawton, OK),Alliancehealth - Midwest (Midwest City, OK),Mercy Hospital Ardmore (Ardmore, OK),Hillcrest Hospital South (Tulsa, OK),Northeastern Health System (Tahlequah, OK),Alliancehealth - Deaconess (Oklahoma City, OK),Stillwater Medical Center (Stillwater, OK),St Francis Hospital South (Tulsa, OK),St Anthony Shawnee Hospital (Shawnee, OK),Southwestern Medical Center (Lawton, OK),Jackson County Memorial Hospital (Altus, OK),Alliancehealth - Ponca City (Ponca City, OK),Integris Miami Hospital (Miami, OK)