Collaboration for Outcomes Research and Evaluation (Amegadzie, Lee, Sadatsafavi, Lynd, Johnson), and Respiratory Evaluation Sciences Program (Amegadzie, Lee, Sadatsafavi, Johnson), Faculty of Pharmaceutical Sciences, University of British Columbia; Centre for Health Evaluation and Outcomes Sciences (Lynd), Providence Health Institute; The Centre for Heart Lung Innovation (Sin), St. Paul's Hospital; Divisions of Respirology (Sin) and Respiratory Medicine (Johnson), Department of Medicine, University of British Columbia, Vancouver, BC.
Collaboration for Outcomes Research and Evaluation (Amegadzie, Lee, Sadatsafavi, Lynd, Johnson), and Respiratory Evaluation Sciences Program (Amegadzie, Lee, Sadatsafavi, Johnson), Faculty of Pharmaceutical Sciences, University of British Columbia; Centre for Health Evaluation and Outcomes Sciences (Lynd), Providence Health Institute; The Centre for Heart Lung Innovation (Sin), St. Paul's Hospital; Divisions of Respirology (Sin) and Respiratory Medicine (Johnson), Department of Medicine, University of British Columbia, Vancouver, BC
CMAJ. 2023 Sep 11;195(35):E1172-E1179. doi: 10.1503/cmaj.221051.
Chronic obstructive pulmonary disease (COPD) is an ambulatory care-sensitive condition, and the rate of hospital admissions for COPD is an indicator of the quality of outpatient care. We sought to determine long-term trends in hospital admissions for COPD in Canada.
Using a comprehensive national database of hospital admissions in Canada, we identified those with a main discharge diagnosis of COPD for patients aged 40 years and older between 2002 and 2017. We calculated sex-specific, age-standardized trends in annual rates of hospital admissions for COPD separately for younger (40-64 yr) and older adults (≥ 65 yr). We used spline regression to examine changes in the admissions trends for each sex and age group.
Over 16 years, 1 134 359 hospital admissions were for COPD. Between 2002 and 2017, the total number of admissions increased by 68.8%, from 52 937 to 89 384. The overall crude admission rate increased by 30.0%, from 368 to 479 per 100 000 population, and the sex-and age-standardized admission rate increased by 9.6%, from 437 to 479 per 100 000 population. Age-standardized rates increased by 12.2% among younger females, by 24.4% among younger males and by 29.8% among older females, but decreased by 9.0% among older males. Over the same period, the all-cause sex-and age-standardized admission rate declined by 23.0%.
Hospital admissions for COPD have increased since 2010, even after adjusting for population growth and aging, and despite declining rates of all-cause hospital admissions. The secular increase in COPD admissions indicates that the burden of COPD on Canadian health care systems is increasing.
慢性阻塞性肺疾病（COPD）是一种门诊治疗敏感的疾病，COPD 的住院率是门诊护理质量的一个指标。我们旨在确定加拿大 COPD 住院率的长期趋势。
利用加拿大全面的住院患者数据库，我们确定了 2002 年至 2017 年期间年龄在 40 岁及以上的患者中，以主要出院诊断为 COPD 的患者。我们分别计算了年轻（40-64 岁）和老年（≥65 岁）人群中 COPD 年住院率的性别和年龄标准化趋势。我们使用样条回归来检查每个性别和年龄组的入院趋势变化。
在 16 年期间，共有 1134359 例 COPD 患者住院。2002 年至 2017 年间，住院人数增加了 68.8%，从 52937 例增加到 89384 例。总住院率增加了 30.0%，从每 10 万人 368 例增加到 479 例，性别和年龄标准化的住院率增加了 9.6%，从每 10 万人 437 例增加到 479 例。年轻女性的年龄标准化率增加了 12.2%，年轻男性增加了 24.4%，老年女性增加了 29.8%，但老年男性下降了 9.0%。同期，所有原因的性别和年龄标准化的住院率下降了 23.0%。
自 2010 年以来，COPD 的住院率一直在上升，尽管考虑到人口增长和老龄化，以及所有原因的住院率下降，但这种趋势仍在继续。COPD 住院率的长期上升表明 COPD 对加拿大医疗保健系统的负担正在增加。
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