Compared to rural hospitals, urban hospitals treating COPD patients are more expensive but have higher incidences of ICU admission, shock, and acute respiratory failure, according to research at Chest 2017 reported by Medpage Today.

In a nationwide analysis of hospitalization outcomes, patients admitted to urban locations had more ICU admissions, shock, and acute respiratory failure versus those admitted to rural hospitals, according to Syed A. Ahsan, MD, of Mount Sinai St Luke’s and Mount Sinai West in New York City, and colleagues.

Ahsan said the disparity may be due, in part, to greater air pollution and allergen exposure in urban settings, which could mean patients are sicker when they enter urban hospitals. Urban hospitals may also be treating sicker COPD patients transferred from rural hospitals, and urban patients may be less compliant with medications and physician visits, he added.