Oxygen therapy use in older adults with chronic obstructive pulmonary disease

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Rationale: Oxygen therapy improves survival and function in severely hypoxemic chronic obstructive pulmonary disease (COPD) patients based on two landmark studies conducted over 40 years ago. We hypothesize that oxygen users in the current era may be very different. We examined trends and subject characteristics associated with oxygen therapy use from 2001-2010 in the United States. Methods: We examined Medicare beneficiaries with COPD who received oxygen from 2001 to 2010. COPD subjects were identified by: 1) ≥2 outpatient visits >30 days apart within one year with an encounter diagnosis of COPD; or 2) an acute care hospitalization with COPD as the primary or secondary discharge diagnosis. Oxygen therapy and sustained oxygen therapy were defined as ≥1 and ≥11 claims for oxygen, respectively, in the durable medical equipment file in a calendar year. Primary outcome measures were factors associated with oxygen therapy and sustained oxygen therapy over the study period. Results: Oxygen therapy increased from 33.7% in 2001 to 40.5% in 2010 (p-value of trend <0.001). Sustained oxygen therapy use increased from 19.5%in 2001, peaked in 2008 to 26.9%and declined to 18.5%in 2010. The majority of subjects receiving oxygen therapy and sustained oxygen therapy were female. Besides gender, factors associated with any oxygen use or sustained oxygen therapy were non-Hispanic white race, low socioeconomic status and ≥2 comorbidities. Conclusions: Any oxygen use among fee-for service Medicare beneficiaries with COPD is high. Current users of oxygen are older females with multiple comorbidities. Decline in sustained oxygen therapy use after 2008 may be related to reimbursement policy change.

Original languageEnglish (US)
Article numbere0120684
JournalPLoS One
Volume10
Issue number3
DOIs
StatePublished - Mar 18 2015

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Pulmonary diseases
respiratory tract diseases
Chronic Obstructive Pulmonary Disease
Oxygen
oxygen
therapeutics
Therapeutics
Medicare
Durable Medical Equipment
Comorbidity
medical equipment
Biomedical equipment
Fee-for-Service Plans

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Oxygen therapy use in older adults with chronic obstructive pulmonary disease. / Nishi, Shawn; Zhang, Wei; Kuo, Yong Fang; Sharma, Gulshan.

In: PLoS One, Vol. 10, No. 3, e0120684, 18.03.2015.

Research output: Contribution to journalArticle

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abstract = "Rationale: Oxygen therapy improves survival and function in severely hypoxemic chronic obstructive pulmonary disease (COPD) patients based on two landmark studies conducted over 40 years ago. We hypothesize that oxygen users in the current era may be very different. We examined trends and subject characteristics associated with oxygen therapy use from 2001-2010 in the United States. Methods: We examined Medicare beneficiaries with COPD who received oxygen from 2001 to 2010. COPD subjects were identified by: 1) ≥2 outpatient visits >30 days apart within one year with an encounter diagnosis of COPD; or 2) an acute care hospitalization with COPD as the primary or secondary discharge diagnosis. Oxygen therapy and sustained oxygen therapy were defined as ≥1 and ≥11 claims for oxygen, respectively, in the durable medical equipment file in a calendar year. Primary outcome measures were factors associated with oxygen therapy and sustained oxygen therapy over the study period. Results: Oxygen therapy increased from 33.7{\%} in 2001 to 40.5{\%} in 2010 (p-value of trend <0.001). Sustained oxygen therapy use increased from 19.5{\%}in 2001, peaked in 2008 to 26.9{\%}and declined to 18.5{\%}in 2010. The majority of subjects receiving oxygen therapy and sustained oxygen therapy were female. Besides gender, factors associated with any oxygen use or sustained oxygen therapy were non-Hispanic white race, low socioeconomic status and ≥2 comorbidities. Conclusions: Any oxygen use among fee-for service Medicare beneficiaries with COPD is high. Current users of oxygen are older females with multiple comorbidities. Decline in sustained oxygen therapy use after 2008 may be related to reimbursement policy change.",
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