Why Is This Important?

Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease that causes obstructed airflow from the lungs. Symptoms include breathing difficulty, cough, mucus (sputum) production and wheezing. COPD is caused by long-term exposure to irritating gases or particulate matter, most often from cigarette smoke. People with COPD are at increased risk of developing heart disease, lung cancer and a variety of other conditions. Emphysema and chronic bronchitis are the two most common conditions that contribute to COPD. Chronic bronchitis is inflammation of the lining of the bronchial tubes, which carry air to and from the air sacs (alveoli) of the lungs. It's characterized by daily cough and mucus (sputum) production. Emphysema is a condition in which the alveoli at the end of the smallest air passages (bronchioles) of the lungs are destroyed as a result of damaging exposure to cigarette smoke and other irritating gases and particulate matter. Chronic lower respiratory disease, primarily COPD, was the fourth leading cause of death in the United States in 2019. Over eleven million Americans are believed to have been diagnosed with COPD.

Definition

Inpatient hospitalizations with a primary diagnosis of chronic obstructive pulmonary disease (COPD). Primary diagnosis of COPD, defined by ICD-9 490-492, 493.2 (only when 490-492 or 496 is present), 496 or ICD-10 codes J40-44.

Data Sources

• Hospital Discharge Data Collection System (NJDDCS), Health Care Quality and Assessment, New Jersey Department of Health
  (https://nj.gov/health/healthcarequality/health-care-professionals/njddcs/)
• American Community Survey, U.S. Census Bureau
  (https://www.census.gov/programs-surveys/acs/)

How the Measure is Calculated

How Are We Doing?

Since 2017, the inpatient hospitalization rate has shown a steady decrease, however some of the decline in hospitalizations for COPD in 2020 is likely a result of the COVID-19 pandemic due to residents' fears of going to the hospital and being exposed to COVID. Inpatient hospitalization rates for COPD do not represent the total burden of the illness. Most cases of COPD are managed without hospitalization. Individuals with COPD prevent hospitalization through avoidance of triggers and medical management. In addition, many people with COPD are treated in emergency departments and are not included in inpatient hospitalization statistics. Hospitalization rates measure a severe outcome of this disease. COPD inpatient hospitalization rates vary widely among New Jersey counties. Rates for inpatient hospitalizations are highest in Cape May and Cumberland Counties. Disparities in inpatient hospitalization and emergency department visit rates likely reflect differences in: smoking; access to effective medical management; co-existing chronic diseases; and environmental or occupational triggers.