Chronic obstructive pulmonary disease (COPD) is a chronic health condition that obstructs airflow to the lungs, causing difficulty in breathing. COPD is one of the top ten causes of death in the U.S. and is a group of diseases that includes emphysema and chronic bronchitis. Common symptoms include coughing, wheezing, shortness of breath, difficulty taking deep breaths, and excess mucus. In the U.S., tobacco smoke is the main cause of COPD, but environmental exposures can also cause it.

Source: About COPD. (2024, May 15).  CDC. Retrieved from  https://www.cdc.gov/copd/about/index.html

Emergency department (ED, also known as emergency room) visit data is used to assess the extent and severity of disease occurring in specific areas or groups of people. This data can be used to monitor trends over time, identify groups that are at a higher risk of disease, and inform disease prevention programs.

For more information on ED data, visit: https://www.cdc.gov/asthma/data-analysis-guidance/emergency-department-data.htm

Interpreting Data

• Age-Adjusted Rates: Rates are presented as an age-adjusted rate with a 95% confidence interval. Age-adjusted rates adjust for differences in the distribution of age between populations, to allow many populations to be compared with one another.

• Confidence Intervals: A confidence interval is a range in which the true value is likely to fall. The confidence level is the probability that the confidence interval includes the true value. This dashboard uses a 95% confidence level.

• Rate per 10,000: A rate per 10,000 is shown in order to make comparisons easier. A rate per 10,000 describes the number of events or illnesses that occurred in a population of 10,000 people. Rates were calculated using the number of ED visits as the numerator. The denominator is the estimated mid-year resident population. The rates were age-adjusted to the 2000 U.S. Standard Population.

About the Data

• Rates presented for emergency department (ED) visits show the number of ED visits per 10,000 population. Rates do not show the proportion of the population with a specific condition or the number of people with an ED visit related to that condition.

• Rates are calculated using MCPHD Epidemiology population estimates, which are based on U.S. Census Bureau population estimates.

• ZIP Codes with fewer than 20 ED visits were excluded to protect patient privacy and maintain the credibility of our estimates.

• ZIP Codes with unstable rates were excluded due to their unreliability. Unstable rates are those where the width of their 95% confidence interval is >60% of the rate itself. In these situations, the rates are unreliable and could provide misleading.

• ZIP Codes 46077 and 46163 were excluded due to having considerable populations outside of Marion County. ZIP Code 46206 was excluded due to no one living in that ZIP Code.

• These data include individuals who live in a Marion County zip code and went to a hospital in Marion County or elsewhere in Indiana. Some zip codes in Marion County cross county lines. In these zip codes, we are not always able to determine if the patient lived in the Marion County portion of the zip code or in a neighboring county. As a result, the rates of these zip codes may be higher than the rate for Marion County portions of the zip codes. Marion County residents who went to an out-of-state hospital are not included. Non-Marion County residents are excluded whenever possible. Residency is based on the address (specifically the zip code) patients provided at the ED.

• ED visit data was collected from ED records containing ICD-10-CM codes that were chosen to include visits where the discharge diagnosis was related to each condition. For COPD ED visits, the ICD-10-CM codes used were J40, J41, J42, J43, and J44.

• Differences in data over time may be due to differences in ICD-10-CM coding, fluctuations in data quality, percentage of data reported, and hospital admission practices.

• A patient who visited the same ED multiple times for the same issue on the same day would only be counted once. If a patient visited multiple EDs for the same issue on the same day, they would be counted once for each ED visit. Transfers between EDs are counted as two separate visits.