Evidence map›Paper›PMID 35342290›Full record

ArticleInternational journal of chronic obstructive pulmonary disease

Relationship of COPD Exacerbation Severity and Frequency on Risks for Future Events and Economic Burden in the Medicare Fee-For-Service Population.

Sanjay Sethi, Barry J Make, Scott B Robinson, Shambhavi Kumar, Michael Pollack, Chad Moretz, Jill Dreyfus, Ann Xi, Dakota Powell, Norbert Feigler

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in International journal of chronic obstructive pulmonary disease. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
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  6. Stage of Disease Among Hospitalized Persons Living With Dementia: A Multisite Study.Journal of the American Medical Directors Association · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Sanjay SethiUniversity at Buffalo, Buffalo, NY, USA.ORCID 0000-0003-0809-7604
Barry J MakeNational Jewish Health, Denver, CO, USA.ORCID 0000-0003-4349-8745
Scott B RobinsonAvalere, Health Economics and Advanced Analytics, Washington, DC, USA.ORCID 0000-0001-6661-5284
Shambhavi KumarAvalere, Health Economics and Advanced Analytics, Washington, DC, USA.
Michael PollackAstraZeneca, Biopharmaceuticals Medical, Wilmington, DE, USA.
Chad MoretzFormerly Avalere, Washington, DC, USA.
Jill DreyfusFormerly Avalere, Washington, DC, USA.
Ann XiFormerly Avalere, Washington, DC, USA.
Dakota PowellFormerly Avalere, Washington, DC, USA.ORCID 0000-0003-2077-6407
Norbert FeiglerAstraZeneca, Biopharmaceuticals Medical, Wilmington, DE, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Purpose: To quantify the effects of moderate and/or severe chronic obstructive pulmonary disease (COPD) exacerbations on future exacerbations and healthcare costs in Medicare Fee-For-Service beneficiaries. Patients and Methods: A retrospective cohort study of patients ≥40 years of age, with continuous enrollment from 2015 to 2018, with an index COPD diagnosis defined as first hospitalization, emergency department visit, or first of two outpatient visits (≥30 days apart) in 2015 with a claim for chronic bronchitis, emphysema, or chronic airway obstruction. Patients were stratified by baseline exacerbation categories in year one (YR1) and subsequently evaluated in YR2 and YR3: (A) none; (B) 1 moderate; (C) ≥2 moderate; (D) 1 severe; and (E) ≥2, one being severe. Moderate exacerbations were defined as COPD-related outpatient/ED visits with a corticosteroid/antibiotic claim within ±7 days of the visit and severe exacerbations as hospitalizations with a primary COPD diagnosis. Total all-cause costs for Categories B-E were compared to reference Category A using generalized linear models and inflation adjusted to 2019 dollars. Results: A total of 1,492,108 patients met study criteria with a mean (±SD) age of 70.9±10.9. In YR1, nearly 40% of patients experienced ≥1 moderate and/or severe exacerbations. Patients having multiple exacerbations, regardless of severity were 2-4 times more likely to experience an exacerbation during YR2 and YR3. Adjusted costs ranged between $24,000 and $26,600 for all categories for YR2 and YR3. Adjusted YR2 costs for Category D and E were $1421 and $1548 higher than those without an exacerbation (Category A YR2 $25,084, YR3 $24,282; p<0.0001). The respective YR3 adjusted costs were $2062 and $2117 higher than those without an exacerbation (Category A; p<0.0001), representing an increase of 6-8% and 8-9% for YR2 and YR3. Conclusion: Medicare patients with recent moderate or severe exacerbations, or at least two exacerbations per year are at significant risk for future exacerbations and incur higher all-cause costs.

Indexed as

Pulmonary Disease, Chronic ObstructiveAgedDisease ProgressionFinancial StressHealth Care CostsHumansMedicareRetrospective StudiesUnited Stateschronic obstructive pulmonary diseasecostsexacerbationsmaintenance therapymedicare

Identifiers

PMID35342290
PMCPMC8948172

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.