Comorbidity Patterns in Chronic Obstructive Pulmonary Disease and Their Associations with Service Utilization

Background The prevalence of combinations of comorbidities and their associations with inpatient service utilization and readmission among patients with chronic obstructive pulmonary disease (COPD) have not been extensively examined. To address this gap in knowledge, an observational prospective stu...

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Main Authors: Yanran Duan, Hang Fu, Changying Chen, Yaojun Zhao, Shuai Jiang, Chengzeng Wang
Format: Article
Language:English
Published: Taylor & Francis Group 2024-12-01
Series:COPD
Subjects:
Online Access:https://www.tandfonline.com/doi/10.1080/15412555.2024.2414793
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author Yanran Duan
Hang Fu
Changying Chen
Yaojun Zhao
Shuai Jiang
Chengzeng Wang
author_facet Yanran Duan
Hang Fu
Changying Chen
Yaojun Zhao
Shuai Jiang
Chengzeng Wang
author_sort Yanran Duan
collection DOAJ
description Background The prevalence of combinations of comorbidities and their associations with inpatient service utilization and readmission among patients with chronic obstructive pulmonary disease (COPD) have not been extensively examined. To address this gap in knowledge, an observational prospective study was conducted using retrospective data.Aims To identify patterns of comorbidities linked to length of hospital stay, daily expenses, and one-year readmission.Methods The 30 most common comorbidities were identified in patients with secondary diagnoses using the association rule mining (ARM) method. Regression models were used to examine the relationships between combinations of comorbidities and service utilization, with adjustments for covariates.Results The five most prevalent comorbidities were pulmonary heart disease (40.99%), ischemic heart disease (38.97%), heart failure (36.77%), hypertension (34.11%), and respiratory disorders (19.12%). Most combinations of comorbidities identified by ARM showed significant associations with an extended length of stay (>13 days), increased daily expenses (>930 CNY), and reduced readmission rates. Among these combinations, glycoprotein metabolism disorder had the strongest association with prolonged length of stay (adjusted odds ratio [aOR]): 1.89, 95% confidence interval [CI]: 1.82–1.95). Conversely, the combination of other brain diseases and respiratory failure was linked to higher daily expenses (aOR: 11.34, 95% CI: 10.58–12.15), and the presence of pulmonary heart disease was associated with elevated one-year readmission rates (aOR: 1.41, 95% CI: 1.37–1.46).Conclusion Common combinations of comorbidities among inpatients with COPD were identified from an extensive collection of discharge medical records. Furthermore, the associations between comorbidities, inpatient service usage, and readmission rates were determined.
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spelling doaj-art-0e0d71ef46f344b8a19aa99a1145029f2024-12-26T08:50:45ZengTaylor & Francis GroupCOPD1541-25551541-25632024-12-0121110.1080/15412555.2024.2414793Comorbidity Patterns in Chronic Obstructive Pulmonary Disease and Their Associations with Service UtilizationYanran Duan0Hang Fu1Changying Chen2Yaojun Zhao3Shuai Jiang4Chengzeng Wang5Office Department, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaOffice Department, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaOffice Department, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaOperation Management Department, Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, ChinaOffice Department, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaOffice Department, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaBackground The prevalence of combinations of comorbidities and their associations with inpatient service utilization and readmission among patients with chronic obstructive pulmonary disease (COPD) have not been extensively examined. To address this gap in knowledge, an observational prospective study was conducted using retrospective data.Aims To identify patterns of comorbidities linked to length of hospital stay, daily expenses, and one-year readmission.Methods The 30 most common comorbidities were identified in patients with secondary diagnoses using the association rule mining (ARM) method. Regression models were used to examine the relationships between combinations of comorbidities and service utilization, with adjustments for covariates.Results The five most prevalent comorbidities were pulmonary heart disease (40.99%), ischemic heart disease (38.97%), heart failure (36.77%), hypertension (34.11%), and respiratory disorders (19.12%). Most combinations of comorbidities identified by ARM showed significant associations with an extended length of stay (>13 days), increased daily expenses (>930 CNY), and reduced readmission rates. Among these combinations, glycoprotein metabolism disorder had the strongest association with prolonged length of stay (adjusted odds ratio [aOR]): 1.89, 95% confidence interval [CI]: 1.82–1.95). Conversely, the combination of other brain diseases and respiratory failure was linked to higher daily expenses (aOR: 11.34, 95% CI: 10.58–12.15), and the presence of pulmonary heart disease was associated with elevated one-year readmission rates (aOR: 1.41, 95% CI: 1.37–1.46).Conclusion Common combinations of comorbidities among inpatients with COPD were identified from an extensive collection of discharge medical records. Furthermore, the associations between comorbidities, inpatient service usage, and readmission rates were determined.https://www.tandfonline.com/doi/10.1080/15412555.2024.2414793Chronic obstructive pulmonary diseasecomorbiditieslength of staydaily expensesone-year readmissionassociation rule mining
spellingShingle Yanran Duan
Hang Fu
Changying Chen
Yaojun Zhao
Shuai Jiang
Chengzeng Wang
Comorbidity Patterns in Chronic Obstructive Pulmonary Disease and Their Associations with Service Utilization
COPD
Chronic obstructive pulmonary disease
comorbidities
length of stay
daily expenses
one-year readmission
association rule mining
title Comorbidity Patterns in Chronic Obstructive Pulmonary Disease and Their Associations with Service Utilization
title_full Comorbidity Patterns in Chronic Obstructive Pulmonary Disease and Their Associations with Service Utilization
title_fullStr Comorbidity Patterns in Chronic Obstructive Pulmonary Disease and Their Associations with Service Utilization
title_full_unstemmed Comorbidity Patterns in Chronic Obstructive Pulmonary Disease and Their Associations with Service Utilization
title_short Comorbidity Patterns in Chronic Obstructive Pulmonary Disease and Their Associations with Service Utilization
title_sort comorbidity patterns in chronic obstructive pulmonary disease and their associations with service utilization
topic Chronic obstructive pulmonary disease
comorbidities
length of stay
daily expenses
one-year readmission
association rule mining
url https://www.tandfonline.com/doi/10.1080/15412555.2024.2414793
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AT yaojunzhao comorbiditypatternsinchronicobstructivepulmonarydiseaseandtheirassociationswithserviceutilization
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