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Regional Differences in Hospitalizations among Patients Admitted with Chronic Obstructive Pulmonary Disease
Alhareth Alsagban1, Scott Mitchell Wright1, Che' Matthew Harris1
1From the Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Southern Medical Journal
|October 1, 2025
Summary
Patients hospitalized with chronic obstructive pulmonary disease (COPD) in the Northeast experienced worse outcomes and higher costs compared to those in the South. Colder temperatures may influence COPD exacerbations, impacting hospitalizations.
Area of Science:
- Environmental Health
- Pulmonary Medicine
- Health Services Research
Background:
- Extreme temperatures adversely affect pulmonary function.
- Geographic variations in ambient temperature may influence health outcomes for respiratory conditions.
Purpose of the Study:
- To investigate the association between regional ambient temperature variability and hospital outcomes for patients admitted with chronic obstructive pulmonary disease (COPD) in the United States.
- To compare mortality, resource utilization, and discharge disposition for COPD hospitalizations between the US Northeast and South.
Main Methods:
- Utilized the 2016-2019 National Inpatient Sample database.
- Compared adult patients hospitalized with COPD in the US Northeast versus the US South.
- Performed multivariable regression analyses to assess outcomes.
Main Results:
- Patients in the Northeast had higher adjusted odds of in-hospital mortality (AOR 1.1, P=0.03) and lower likelihood of discharge to home (AOR 0.63, P<0.01) compared to the South.
- Northeast patients experienced longer hospital stays (+0.19 days, P<0.01) and incurred greater hospital charges (+$3728, P<0.01).
- Lowest COPD hospitalization rates in both regions occurred during the hottest months (July-August).
Conclusions:
- COPD hospitalizations in the Northeast were associated with worse clinical outcomes and increased resource utilization compared to the South.
- Higher admission rates during colder months suggest a potential influence of colder ambient temperatures on COPD exacerbations.
- Findings highlight the impact of environmental factors on COPD patient management and healthcare resource allocation.
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