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Hospital Burden of Chronic Obstructive Pulmonary Disease in Hong Kong - The Trend from 2006 to 2014
Hok Sum Chan1, Fanny Wai San Ko2, Johnny Wai Man Chan3
1Department of Medicine, Alice Ho Miu Ling Nethersole Hospital, Hong Kong Special Administrative Region (HKSAR), People's Republic of China.
Insights
Hospital admissions for Chronic Obstructive Pulmonary Disease (COPD) decreased in Hong Kong from 2006 to 2014. This trend suggests reduced disease severity, though pneumonia-related deaths increased in COPD patients.
Area of Science:
- Pulmonary Medicine
- Public Health
- Epidemiology
Background:
- Chronic Obstructive Pulmonary Disease (COPD) is a significant contributor to hospital admissions.
- Understanding the hospital burden and trends of COPD is crucial for healthcare planning.
Purpose of the Study:
- To analyze the hospital burden and temporal trends of COPD in Hong Kong from 2006 to 2014.
- To examine demographic shifts, healthcare resource utilization, and mortality patterns in hospitalized COPD patients.
Main Methods:
- A multi-center, retrospective study analyzing anonymized data of COPD patients discharged from Hong Kong public hospitals.
- Data included demographics, healthcare resource use, ventilatory support, medications, and mortality.
Main Results:
- Total COPD patient headcount and admissions declined between 2006 and 2014, with a notable decrease in female patients.
- Utilization of non-invasive ventilation (NIV) peaked in 2010 and subsequently decreased, while long-acting bronchodilator prescriptions rose significantly.
- COPD and pneumonia were leading causes of death, with increasing pneumonia-related mortality and decreasing COPD-related mortality.
Conclusions:
- The declining COPD hospital burden and severity indicators suggest potential impacts of reduced smoking and tuberculosis rates.
- An increasing trend in pneumonia mortality among COPD patients highlights the need for vaccination.
- Recommendations include implementing timely vaccination programs for COPD patients to mitigate risks.
Background:
Chronic obstructive pulmonary disease (COPD) is a common cause for hospital admission. This study aims to review the hospital burden of COPD in Hong Kong (HK) and the trend from year 2006 to 2014.
Methods:
A multi-center, retrospective study of the characteristics of COPD patients discharged from the public hospitals of HK from year 2006 to 2014. Anonymized data retrieval and analysis were performed. The demographic data of the subjects, use of health-care resources, ventilatory support, medications used and mortality of the subjects were analyzed.
Results:
Total patient headcount (HC) and admission number reduced from 10,425 and 23,362 in year 2006 to 9613 and 19,771, respectively, in 2014. There was a progressive reduction of female COPD HC from 2193 (21%) in year 2006 to 1517 (16%) in 2014. The utilization of non-invasive ventilation (NIV) increased rapidly and peaked in 2010 (29%) and decreased thereafter. There was a rapid increase in the prescription of long-acting bronchodilators (from 15% to 64%). COPD and pneumonia were the top causes of death, but death due to pneumonia was rapidly increasing while death due to COPD was progressively decreasing over the period.
Conclusion:
COPD HC and admission number (particularly in female patients) decreased progressively from year 2006 to 2014. There was also a decreasing trend of severity of disease as reflected by lower NIV use (after year 2010) and lower mortality rate due to COPD. Reduced smoking prevalence and tuberculosis (TB) notification rate in the community in the past might have reduced the incidence and severity of COPD and the hospital burden of disease. We observed an increasing trend of mortality due to pneumonia in COPD patients. Appropriate and timely vaccination programs are recommended for COPD patients as in the general elderly population.
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