Age, Race and Gender Spatiotemporal Disparities of COPD Emergency Room Visits in Houston, Texas

Chronic obstructive pulmonary disease (COPD) is one of the major causes of morbidity and mortality in the United State. The investigation of the continuing increase in its prevalence and mortality has increased attempts to further understand its causes and how to manage it. Understanding the spatial and temporal distribution of COPD emergency room (ER) visits in Harris County (Houston) can guide these efforts in a uniform yet diverse setting like this one. The objectives of this study were to identify the temporal and spatial variations of COPD emergency room visits adjusted by age, gender, ethnicity, day of the week, month, and year, and to estimate the odds ratio of COPD emergency room visits adjusted by the six risk factors. The dataset used were extracted from two resources: ER Utilization Study and Harris County centroid coordinates. Exploratory statistical analyses were conducted to study the spatiotemporal disparities and investigate associations. Logistic regression was performed to estimate the odds ratio of COPD primary diagnosis adjusted for age, race, gender, day of the week, month, and year. The number of COPD ER visits kept increasing from 2004 throughout 2009 but there was a significant increase after the year 2005. Spring and summer had lower visits compared to winter and autumn. Lowest visits were during June and July and higher during December and January. Tuesdays had the highest number of visits compared to the remaining days of the week with Saturdays having had the lowest number of visits. Temporal analyses show the continuous increase in COPD ER visits in Houston as well as the consistent spatial disparities between zip regions. After adjustment for age, race, gender, day of the week, month, and year, there were statistically significant associations between emergency room chronic obstructive pulmonary disease diagnoses in Houston, Texas, with these six predictors.