BACKGROUND Several major risk factors for chronic obstructive pulmonary disease (COPD), such as population aging, smoking rates, and air pollution levels are rapidly changing, causing inevitable changes in the population burden of COPD. We determined the excess direct costs of COPD and their trend from 2001 to 2020. METHODS Using administrative health data from British Columbia, Canada, we created a retrospective matched cohort of physician-diagnosed COPD patients and non-COPD individuals. Excess direct medical costs (2020 $CAD) were estimated by analysing hospital records, outpatient services, medications, and community-care services. Comorbidity classes were assessed using the International Classification of Diseases codes. Excess COPD costs were estimated as the adjusted difference in direct medical costs between COPD and non-COPD cohorts. RESULTS There were 208 554 and 404 703 individuals in the COPD and non-COPD cohorts, respectively (47.8% female; mean baseline age 69.1 and 68.2 years, respectively). Direct medical costs for COPD were $9224 per patient-year (/PY), compared to $3396/PY for non-COPD, giving rise to excess costs of $5828/PY (95% confidence interval [CI] 5759-5897). Excess costs increased by 48% over the study period. Excess costs due to comorbidities were $3588/PY (95% CI 3554-3622), with cardiovascular-related conditions alone exceeding the costs attributed to COPD ($1375/PY versus $904/PY). CONCLUSION Despite multifaceted prevention and management initiatives, COPD-related economic burden is increasing, with the majority of costs due to comorbid conditions. Rising per-patient costs, combined with the flat or increasing prevalence of COPD in many jurisdictions, indicates a significant increase in COPD burden.

中文翻译：

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慢性阻塞性肺疾病超额成本的 20 年趋势。


背景 慢性阻塞性肺病 （COPD） 的几个主要危险因素，如人口老龄化、吸烟率和空气污染水平正在迅速变化，导致 COPD 的人口负担不可避免地发生变化。我们确定了 2001 年至 2020 年 COPD 的超额直接成本及其趋势。方法 使用来自加拿大不列颠哥伦比亚省的行政健康数据，我们创建了一个由医生诊断的 COPD 患者和非 COPD 个体的回顾性匹配队列。超额直接医疗费用 （2020 $CAD） 是通过分析医院记录、门诊服务、药物和社区护理服务来估计的。使用国际疾病分类代码评估合并症类别。超额 COPD 成本估计为 COPD 和非 COPD 队列之间直接医疗成本的调整差异。结果 COPD 和非 COPD 队列中分别有 208 554 和 404 703 人 （47.8% 为女性;平均基线年龄分别为 69.1 岁和 68.2 岁）。COPD 的直接医疗费用为每患者年 （/PY） 9224 美元，而非 COPD 为 3396 美元/PY，导致超额费用为 5828 美元/PY（95% 置信区间 [CI] 5759-5897）。在研究期间，超额成本增加了 48%。合并症导致的超额费用为 3588 美元/PY（95% CI 3554-3622），仅心血管相关疾病就超过了 COPD 的成本（1375 美元/PY 对 904 美元/PY）。结论 尽管采取了多方面的预防和管理举措，但 COPD 相关的经济负担正在增加，其中大部分费用是由于合并症。不断上升的每位患者成本，加上许多司法管辖区 COPD 的患病率持平或不断上升，表明 COPD 负担显着增加。