A study expected to be published in the December issue of the medical journal Chest shows that Americans with chronic obstructive pulmonary disease (COPD) receive only about half of the recommended medical care, with care varying significantly based on individual conditions. COPD is the fourth leading cause of death in the United States.

In the Chest article, the authors state, "[W]e can estimate excess mortality that might result from failure to provide care specified in individual indicators. For example, only 32% of COPD patients with baseline hypoxia received home oxygen for routine management. From estimates of the numbers of hypoxic patients in the United States and the mortality reduction demonstrated from the Nocturnal Oxygen Therapy Trial, 27,000 to 54,000 annual deaths may have been reduced by appropriate oxygen use."

Dr. Richard A. Mularski is lead author of the study and a physician-researcher with the Center for Health Research, Kaiser Permanente. The study was conducted by RAND Health and was supported by the Robert Wood Johnson Foundation and Veterans Affairs Health Administration, which supported a fellowship for Mularski. http://www.rand.org

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