What role do hospitals play in treating COPD?

Patients may require admission to hospital for severe acute exacerbations of COPD

Acute exacerbations of COPD (flare-ups) are frequently due to respiratory tract infections. They have also been associated with increases in exposure to air pollution and changes in ambient temperature. Episodes that are life threatening sometimes require temporary assistance with breathing.

Data from the AIHW National Hospital Morbidity Database (NHMD) show that in 2014–15 there were 66,540 hospitalisations of people 45 years and over where COPD was the principal diagnosis. The rate of hospitalisation for COPD among those aged 45 and over was 690 per 100,000 population.

The hospitalisation rate for males aged 45 years and over declined 14% in the ten years from 2005–06 to 2014–15, from 912 to 785 per 100,000 population (Figure 1).

The female hospitalisation rate varied little over the same period, remaining around 600 per 100,000 population.

Figure 1: COPD hospitalisations, ages 45+, 2005–06 to 2014–15

The horizontal line chart shows that the rate of COPD hospitalisations for men declined from 912 to 785 per 100,000 population, while the rate for women remained at around 600 hospitalisations per 100,000 population between 2005–06 to 2014–15.

Notes

  1. Age standardised to the 2001 Australian Standard Population.
  2. COPD classified according to International Classification of Diseases, 10th Revision, Australian Modification (ICD-10-AM) (8th edition for 2013–14 to 2014–15, earlier editions for 2005–06 to 2012–13) codes J40 to J44.
  3. Hospitalisations for which the care type was reported as Newborn with no qualified days, and records for Hospital boarders and Posthumous organ procurement have been excluded.
  4. COPD occurs mostly in people aged 45 years and over. While it is occasionally reported in younger age groups, in those aged 45 years and over there is more certainty that the condition is COPD and not another respiratory condition. For this reason only hospitalisations for people aged 45 years and over are included in this graph.
  5. Trend data should be interpreted with caution; see the NHMD data quality statement for more information.

Source: AIHW National Hospital Morbidity Database (Data table).

There is a strong seasonal driver of COPD exacerbations

Admissions to hospital for COPD are highest in winter and early spring. This matches and is related to the trend for acute respiratory infections (e.g. rhinovirus (common cold), influenza, pneumonia and acute bronchitis) (Figure 2). 

Figure 2: Hospitalisations for acute respiratory infection (ARI) or COPD, ages 45+, by month, 2010–14

The horizontal line chart shows that between 2010 and 2014, admissions to hospital for COPD were highest in winter and early spring. This matches and is related to the trend for acute respiratory infections – although they had a slightly higher prevalence rate than COPD.

Notes

  1. Data obtained from records of hospitalisations, reported by period of hospital admission.

  2. COPD classified according to the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Australian Modification (ICD-10-AM) (8th edition for 2013–14 to 2014–15, earlier editions for 2009–10 to 2012–13) codes J40 to J44 National Centre for Classification of Health.

  3. Acute respiratory infections classified according to the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Australian Modification (ICD-10-AM) codes J00–J22 (e.g. rhinovirus (common cold), influenza, pneumonia and acute bronchitis).

  4. Hospitalisations for which the care type was reported as Newborn with no qualified days, and records for Hospital boarders and Posthumous organ procurement have been excluded.

  5. COPD occurs mostly in people aged 45 years and over. While it is occasionally reported in younger age groups, in those aged 45 years and over there is more certainty that the condition is COPD and not another respiratory condition. For this reason only people aged 45 years and over are included in this graph

  6. Trend data should be interpreted with caution; see the NHMD data quality statement for more information.

Source: AIHW National Hospital Morbidity Database (Data table).

References

  1. AIHW National Hospital Morbidity Database (NHMD) 2014–15 data quality statement.
  2. National Casemix and Classification Centre (NCCC) 2012. The international statistical classification of diseases and related health problems, 10th revision, Australian modification (ICD-10-AM), Australian Classification of Health Interventions (ACHI) and Australian Coding Standards (ACS), 8th edn. Wollongong: University of Wollongong.