Quality of care for older adults with chronic obstructive pulmonary disease and asthma based on comparisons to practice guidelines and smoking status

Table 2 Smoking History and Patterns in Health Care among Older Adults with Obstructive Respiratory Disease, 1992–2002

	Older Adults with Obstructive Respiratory Disease			Older Adults with Obstructive Respiratory Disease & Treated with Pharmacotherapy
	No Pharmacotherapy	Pharmacotherapy *	p-value	No short-acting inhaled bronchodilator	Short-acting inhaled bronchodilator †	p-value
Number of person-years	14,894	6,631		1,995	4,636
Annual use of health care, %
Spirometry examinations	0.08	0.24	<0.01	0.21	0.26	<0.01
Pulmonologist visits	0.08	0.27	<0.01	0.25	0.29	<0.01
Influenza vaccination	0.67	0.77	<0.01	0.73	0.79	<0.01
Emergency room visits	0.20	0.26	<0.01	0.26	0.25	0.59
Number of physician visits	8.94	10.95	<0.01	11.30	11.03	0.99
Number of days in hospital	2.76	4.37	<0.01	5.48	3.86	<0.01
Respiratory medications, %
Corticosteroid inhalers				0.23	0.35	<0.01
Xanthines				0.34	0.26	<0.01
Salmeterol				0.10	0.10	0.82
Leukotriene receptor antagonists				0.04	0.05	0.12
Oxygen				0.49	0.28	<0.01
Smoking History, %
None	0.35	0.24	<0.01	0.28	0.21	<0.01
Former Smoker	0.49	0.61	<0.01	0.58	0.62	<0.01
Current Smoker	0.16	0.15	0.02	0.14	0.17	<0.01
Influenza vaccination	0.67	0.77	<0.01	0.73	0.79	<0.01

* Respiratory treatments include oxygen, ipratropium (Atrovent^®) inhaler, ipratropium-albuterol (Combivent^®) inhaler, xanthines, leukotriene receptor antagonists, short-acting beta antagonist inhalers, salmeterol (Serevent^®), and corticosteroid inhalers.
† Short-acting inhaled bronchodilators (metered dose inhalers and nebulizer solutions) include: beta-agonists ipratropium bromide (Atrovent^®), and the combination of ipratropium bromide and albuterol (Combivent^®) inhalers.
& All health care measures represent utilization over a calendar year.

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