Thousands of lives at stake in fight against chronic lung disease

copdPatients with obstructive lung diseases receive only about 55 percent of recommended medical care, according to a study that reflects the increasing health-care challenges of an aging population.

"The quality of care provided to patients with obstructive lung diseases is not as good as it should be or needs to be," said Dr. Richard Mularski, with Kaiser's Portland-based Center for Health Research.

Mularski is lead author of the study, which was published in the December issue of the journal Chest. The RAND Corp. study is part of the largest examination of the quality of American health care ever undertaken.

The study followed 260 people with asthma and 169 with chronic obstructive pulmonary disease (COPD), which includes chronic bronchitis and emphysema.

Obstructive lung disease affects from 12 million to 50 million Americans. COPD is the nation's No. 4 cause of death and is a significant factor in decreased quality of life.

Mularski and his fellow researchers estimate that increasing the number of COPD patients who receive appropriate oxygen treatment at home could prevent from 27,000 to 57,000 deaths annually; that would mean continuous oxygen for 19 hours a day, he said.

Testing, medication low

They also found that tests to evaluate lung function among COPD patients were used less than expected, while a very low rate of both COPD and asthma patients were using their medication inhalers appropriately.

"We can make a difference in routine care by targeting disease management," Mularski said.

Unfortunately, "these deficits are not unique" among asthma and COPD patients, Mularski added. "The study looked at 30 routine diseases and the amount of care was at about 55 percent.

"For the most part, it's not that physicians are not doing their best," he said. "Our systems are disorganized and don't provide support: things like database systems that, when care is indicated, can make sure it is delivered."

And the issue will only get worse.

"The key is the complexity of managing chronic diseases with the aging of America," he said. "The number of people over 85 is expected to double to 9 million by 2030. People are living longer, with many more chronic diseases. We need to figure out ways to manage them."

Tom Vogt writes about health care for The Columbian. Contact him at 360-759-8008


Did you know?

Chronic obstructive pulmonary disease (COPD) refers to two lung diseases, chronic bronchitis and emphysema, that are characterized by airflow obstruction that interferes with normal breathing. The two conditions frequently co-exist, so physicians prefer the term COPD; it is the nation's fourth-leading cause of death, claiming the lives of 122,283 Americans in 2003.

Source: American Lung Association