COPD in VA hospitals

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Abstract

The Department of Veterans Affairs (VA) Health Care System is the largest integrated single payer system in the United States. Its primary mission is to provide primary care, specialized care, and related medical and social support services to veterans. Much time and resources are expended on chronic obstructive pulmonary disease, known as COPD, at VA hospitals and clinics, thereby justifying the development of multifaceted strategies to address this problem. This article discusses the special problems of COPD in veterans who use VA facilities. The article also highlights the contributions of the VA to the research, training, and development of clinical practice guidelines for the management of this pervasive disease and presents the challenges that threaten its role in this area.

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      An estimated 10 million adults in the US have physician-diagnosed chronic obstructive pulmonary disease (COPD) [1]. Chronic obstructive pulmonary disease was the fourth leading cause of death in the US in 2001 [2] and was the fourth most common discharge diagnosis from Veterans Affairs Medical Centers (VAMCs) in 2003 [3]. Estimates vary, but approximately 40% of COPD patients have clinical depression [4], and 10%–30% have generalized anxiety disorder [5].

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