Current and future direct healthcare cost burden of chronic obstructive pulmonary disease in Alberta, Canada
Bibliographic record
Abstract
OBJECTIVES: To examine the resource use and healthcare costs for chronic obstructive pulmonary disease (COPD) in Alberta, Canada between 2008 and 2016 and model the future costs to 2030.METHODS: Interlinked hospitalization, ambulatory care, practitioner claims and drug databases in Alberta were used to identify COPD healthcare encounters and medications. Canadian Institution for Health Information Cost of a Standard Hospital Stay was used to calculate hospitalization and ambulatory costs and Alberta Drug Benefit List was used to provide drug unit costs. Linear regression and generalized linear model were used to project future COPD healthcare costs.RESULTS: The study included 68,812 hospitalizations, 159,750 ambulatory care visits, 1,239,801 practitioner claims and 3,103,408 drug dispensing events of 70,585 unique patients with COPD. The prevalence of health services use decreased (2008: 1,831 per 100,000 population; 2016: 1,683; p < 0.001), while the patient age increased over time (mean age, 2008: 67.6 years; 2016: 69.9 years; p < 0.001). Number of hospitalizations increased but hospital length of stay decreased over time. A hospitalization with COPD costs CAN$12,994 while an ambulatory care visit costs CAN$602. Annual healthcare costs increased from CAN$115.5 in 2008 to CAN$170.5 million in 2016 (p < 0.001). Hospitalization and drug costs accounted for 65.5% and 19.7%, respectively. Annual healthcare costs for COPD were projected to reach CAN$412.5 million in 2030.CONCLUSION: The healthcare cost burden of COPD for health systems is substantial and is projected to increase further. Interventions to shift COPD management from inpatient to less costly outpatient and home settings to alleviate the cost burden are needed.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.003 | 0.005 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".