Many COPD patients get sub-par hospital care in US

NEW YORK (Reuters Health) – Just a third of patients
receive ideal care when they’re hospitalized for a flare-up of
chronic obstructive pulmonary disease (COPD) such as emphysema,
researchers based in Massachusetts and North Carolina have
found.

Ideal care means getting all the tests, treatments and
interventions recommended in the treatment guidelines for this
condition, and none of those that are not.

Dr. Peter K. Lindenauer, from Baystate Medical Center in
Springfield, Massachusetts, and colleagues note in the Annals
of Internal Medicine that COPD exacerbation is one of the ten
most common reasons for hospital admission among adults in the
US and accounts for over $18 billion in annual healthcare
costs.

The researchers analyzed data from nearly 70,000 patients
hospitalized for a COPD flare-up in the US in 2001, to
determine the percentage of patients who received care in
accordance with guidelines produced by the American College of
Physicians and the American College of Chest Physicians.

Sixty-six percent of subjects received all of the
recommended interventions, while 45 percent of subjects
received at least one non-recommended intervention. As noted,
only 33 percent of subjects received all of the recommended
interventions and none of the non-recommended ones.

Wide variability was seen among the hospitals in the
management of COPD patients.

The quality of care for patients hospitalized for acute
exacerbations of COPD may be improved by increasing the use
recommended therapies, “decreasing the use of unnecessary and
potentially harmful treatments, and reducing variation in
practice across hospitals,” Lindenauer and colleagues conclude.

SOURCE: Annals of Internal Medicine, June 20 2006.