Hospital Burden of Chronic Obstructive Pulmonary Disease in Hong Kong – The Trend from 2006 to 2014

Abstract

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.

Keywords:

• hospital burden
• mortality
• smoking
• old tuberculosis
• pneumonia

Acknowledgments

We would like to thank Ms. Reling Tse of Medial Records Office for generating the patient statistics from CDARS. We would also like to thank Dr Thomas Mok, Dr KS Lau, Dr Wilson Yee, Dr YC Yeung, Dr Veronica Chan, Dr CH Chau, Dr FY Kong, Dr Jane Cheung, Dr PY Tse as co-ordinators for the hospitals involved in this study and the HK Lung Foundation for sponsoring this project.

Disclosure

All authors reported no conflicts of interest in this work and received no personal fee from any grant or commercial companies.