COPD Incidence Varies By an Order of Magnitude In Oklahoma


In Chronic Obstructive Pulmonary Disease (COPD)

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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.

COPD Discharges as percentage of 2016 Total Medicare Dishcarges

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:

  1. Integris Baptist Medical Center
  2. St Anthony Hospital
  3. Oklahoma University Medical Center
  4. Mercy Hospital Oklahoma City
  5. Integris Southwest Medical Center
  6. Eastar Health System Main
  7. Oklahoma Heart Hospital
  8. Comanche County Memorial Hospital
  9. Alliancehealth - Midwest
  10. Mercy Hospital Ardmore
  11. Hillcrest Hospital South
  12. Northeastern Health System
  13. Alliancehealth - Deaconess
  14. Stillwater Medical Center
  15. St Francis Hospital South
  16. St Anthony Shawnee Hospital
  17. Southwestern Medical Center
  18. Jackson County Memorial Hospital
  19. Alliancehealth - Ponca City
  20. Integris Miami Hospital

DEXUR PRO MEMBERS GET ACCESS TO:

  1. Medicare Inpatient Discharges
  2. Total Discharges All COPD
  3. Total Discharges After Exclusion All COPD
  4. All Cause 30 Day Readmissions All COPD
  5. 30 Day COPD Readmissions All COPD
  6. 30 Day COPD Readmission Rate All COPD
  7. 30 to 60 Day COPD Readmissions All COPD
  8. 30 to 60 Day COPD Readmission Rate All COPD
  9. COPD Incidence (Total Discharges All COPD divided by Medicare Inpatient Discharges)
  10. All Cause 30 Day Readmissions Rate for patients discharged with COPD (All Cause Readmissions All COPD divided by Total Discharges After Exclusion All COPD)

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)


ABOUT THE AUTHOR

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James Pitt

James Pitt is a science writer with experience in medical devices and textbook publishing. His hobbies include reading, flintknapping, and squinting at RStudio. He received a bachelor's in Human Evolutionary Biology from Harvard.