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Abstract

ABSTRACTCHARLES N. DAVIS JR. Chronic Obstructive Pulmonary Disease in U.S. Veterans: Comorbidity, Ocular Pathology, and Cost of Care (Under the direction of DR. WILLIAM BRANDON)Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality among veterans. The present study investigated the identified comorbidities, ocular diagnoses, and the cost and utilization of care for veterans diagnosed with COPD compared to veterans without COPD. The study included the population of veterans that were enrolled for primary care at the Salisbury Veteran Affairs Health Care Center from January 1, 2016 to December 31, 2018. This case-control study comprised veterans between the ages of 50 years and 90 years. Structured Query Language (SQL) was used to identify the eligible study subjects, the sociodemographic variables, and the select ICD-9-CM and ICD-10-CM specific diagnoses. Statistical analyses used multivariant logistic models for the comorbidities and ocular diagnoses, and multivariant conditional quantile regression models for the cost and utilization of care. Veterans with COPD were shown to have greater odds for 15 systemic diagnoses compared to veterans without COPD. Cases were shown to be at significantly greater odds for exudative macular degeneration compared to control. Healthcare costs and utilization among veterans with COPD was approximately four times higher than those for veterans without COPD.

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