Data from 2010 on chronic obstructive pulmonary disease (COPD) and asthma in Medicare beneficiaries were analyzed by the Centers for Medicare and Medicaid Services.
Per capita spending on COPD and asthma was $46,764. Spending was 8% higher for males. Although the 2% difference in overall per capita spending for both conditions (asthma, $37,831; COPD, $37,028) was not significant, the amount expended on males was 5.4% more for asthma ($41,157) than for COPD ($39,070). Less money was expended on females for both conditions, but the per capita expense for asthma ($36,454) was 2.3% more than that for COPD ($35,648). Spending on COPD for patients aged <65 years ($47,944) was 5% more than that for asthma ($45,654), but the gap narrowed to 1.8% (COPD, $36,341; asthma, $36,981) in patients aged >65 years. In the case of asthma and COPD comorbidity, 26% more was spent on patients aged <65 years ($57,782) versus those aged >65 years ($45,669).
Prevalence Among Beneficiaries:
As comorbid conditions, asthma and COPD had an overall prevalence of 0.6%. COPD prevalence (3%) among Medicare recipients was about four times that for asthma (0.8%). Among dual Medicare-Medicaid beneficiaries and their Medicare-only counterparts, there were 29% and 19% fewer asthma cases, respectively, in patients aged ≥65 years than in those aged <65 years; in contrast, COPD prevalence increased by 53% and 20%, respectively. Among females aged ≥65 years, prevalence of COPD (10.9%) was more than double that for asthma (4.9%), but among males, COPD prevalence was 11.8% versus 3% for asthma—a threefold increase. COPD and asthma prevalence rose considerably with age progression (3.3% and 0.9%, respectively, for age ≥65 years).
The difference in COPD prevalence among males and females aged 65–74 years was 11%, and the difference widened with age progression—namely, a difference of 23% and 40% for beneficiaries aged 75–84 years and those aged ≥85 years, respectively. Between ages 75–84 years and ≥85 years, COPD prevalence increased 5.3% in males and decreased 7.5% in females. Among females aged >65 years, asthma prevalence decreased with age progression—namely 9%, 7.7%, and 5.5% among those aged 65–74, 75–84, and 85 years, respectively. Asthma prevalence among males aged ≥65 years remained relatively steady (4.9%) across age groups. The prevalence trend for asthma was the reverse of that for COPD; namely, with age progression, the divergence between males and females decreased by 14.7% between ages 65–74 years and 75–84 years, and decreased by 28.7% between age 75–84 years and ≥85 years.
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