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Quantifying comorbidity in individuals with COPD: a population study

Andrea S. Gershon, Graham C. Mecredy, Jun Guan, J. Charles Victor, Roger Goldstein, Teresa To
European Respiratory Journal 2015 45: 51-59; DOI: 10.1183/09031936.00061414
Andrea S. Gershon
1Sunnybrook Health Sciences Centre, Toronto, ON, Canada
2Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
3University of Toronto, Toronto, ON, Canada
4The Hospital for Sick Children, Toronto, ON, Canada
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  • For correspondence: andrea.gershon@ices.on.ca
Graham C. Mecredy
2Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
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Jun Guan
2Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
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J. Charles Victor
2Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
3University of Toronto, Toronto, ON, Canada
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Roger Goldstein
3University of Toronto, Toronto, ON, Canada
5Westpark Healthcare Centre, Toronto, ON, Canada
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Teresa To
2Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
3University of Toronto, Toronto, ON, Canada
4The Hospital for Sick Children, Toronto, ON, Canada
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Abstract

Chronic obstructive pulmonary disease (COPD) has been associated with many types of comorbidity. We aimed to quantify the real world impact of COPD on lower respiratory tract infection, cardiovascular disease, diabetes, psychiatric disease, musculoskeletal disease and cancer, and their impact on COPD through health services.

A population study using health administrative data from Ontario, Canada, in 2008–2012 was conducted. Absolute and adjusted relative rates of ambulatory care visits, emergency department visits and hospitalisations for the comorbidities of interest in people with and without COPD were determined and compared.

Among 7 241 591 adults, 909 948 (12.6%) had COPD. Over half of all lung cancer, a third of all lower respiratory tract infection and cardiovascular disease, a quarter of all low trauma fracture, and a fifth of all psychiatric, musculoskeletal, non-lung cancer and diabetes ambulatory care visits, emergency department visits and hospitalisations in Ontario were used by people with COPD. Individuals with COPD used about five times more health services for lung cancer, and two times more health services for lower respiratory tract infections and cardiovascular disease than people without COPD.

Individuals with COPD use a disproportionate amount of health services for comorbid disease, placing significant burden on the healthcare system.

Abstract

COPD responsible for significant proportion of all hospitalisations, emergency department visits and ambulatory care http://ow.ly/xVZMZ

Footnotes

  • For editorial comments see Eur Respir J 2015; 45: 14–17 [DOI: 10.1183/09031936.00148014].

  • This article has supplementary material available from erj.ersjournals.com

  • Support statement: Andrea Gershon is currently supported by a Fellowship in Translational Research from The Physicians’ Services Incorporated Foundation, Toronto, Canada, and was supported by a New Investigator Award funded by team grant OTG-88591 from the Canadian Institutes of Health Research while working on this study. Teresa To is supported by The Dales Award in Medical Research from the University of Toronto, Toronto. Funding for this project was made available through the Government of Ontario, which had no role in study design, collection, management, analysis, interpretation of data, writing of the report or in the decision to submit the report for publication. This study was also supported by the Institute for Clinical Evaluative Sciences (ICES), which is funded by an annual grant from the Ontario Ministry of Health and Long-Term Care. The opinions, results and conclusions reported in this paper are those of the authors, and are independent from the funding sources. No endorsement by ICES or any of the funding agencies is intended or should be inferred.

  • Conflict of interest: None declared.

  • Received April 1, 2014.
  • Accepted June 6, 2014.
  • Copyright ©ERS 2015
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Quantifying comorbidity in individuals with COPD: a population study
Andrea S. Gershon, Graham C. Mecredy, Jun Guan, J. Charles Victor, Roger Goldstein, Teresa To
European Respiratory Journal Jan 2015, 45 (1) 51-59; DOI: 10.1183/09031936.00061414

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Quantifying comorbidity in individuals with COPD: a population study
Andrea S. Gershon, Graham C. Mecredy, Jun Guan, J. Charles Victor, Roger Goldstein, Teresa To
European Respiratory Journal Jan 2015, 45 (1) 51-59; DOI: 10.1183/09031936.00061414
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