Hospital Burden of Chronic Obstructive Pulmonary Disease in Hong Kong – The Trend from 2006 to 2014
Bibliographic record
Abstract
Hok Sum Chan,1 Fanny Wai San Ko,2 Johnny Wai Man Chan,3 Kah Lin Choo,4 Loletta Kit Ying So,5 David Chi Leung Lam,6 Kit Man Sin,7 Wei Yin Wong,8 Yuk Lun Cheng,1 Maureen Mo Lin Wong9 1Department of Medicine, Alice Ho Miu Ling Nethersole Hospital, Hong Kong Special Administrative Region (HKSAR), People’s Republic of China; 2Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region (HKSAR), People’s Republic of China; 3Department of Medicine, Queen Elizabeth Hospital, Hong Kong Special Administrative Region (HKSAR), People’s Republic of China; 4Department of Medicine, North District Hospital, Hong Kong Special Administrative Region (HKSAR), People’s Republic of China; 5Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong Special Administrative Region (HKSAR), People’s Republic of China; 6Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong Special Administrative Region (HKSAR), People’s Republic of China; 7Department of Medicine and Geriatrics, Tuen Mun Hospital, Hong Kong Special Administrative Region (HKSAR), People’s Republic of China; 8Department of Medicine, Haven of Hope Hospital, Hong Kong Special Administrative Region (HKSAR), People’s Republic of China; 9Department of Medicine and Geriatrics, Caritas Medical Centre, Hong Kong Special Administrative Region (HKSAR), People’s Republic of ChinaCorrespondence: Hok Sum Chan, Department of Medicine, 6/F, Block J, Alice Ho Miu Ling Nethersole Hospital, 11 Chuen On Road, Tai Po, NT, Hong Kong Special Administrative Region (HKSAR), People’s Republic of China, Email chanhs@ha.org.hkBackground: Chronic obstructive pulmonary disease (COPD) is a common cause for hospital admission. This study aims to review the hospital burden of COPD in Hong Kong (HK) and the trend from year 2006 to 2014.Methods: A multi-center, retrospective study of the characteristics of COPD patients discharged from the public hospitals of HK from year 2006 to 2014. Anonymized data retrieval and analysis were performed. The demographic data of the subjects, use of health-care resources, ventilatory support, medications used and mortality of the subjects were analyzed.Results: Total patient headcount (HC) and admission number reduced from 10,425 and 23,362 in year 2006 to 9613 and 19,771, respectively, in 2014. There was a progressive reduction of female COPD HC from 2193 (21%) in year 2006 to 1517 (16%) in 2014. The utilization of non-invasive ventilation (NIV) increased rapidly and peaked in 2010 (29%) and decreased thereafter. There was a rapid increase in the prescription of long-acting bronchodilators (from 15% to 64%). COPD and pneumonia were the top causes of death, but death due to pneumonia was rapidly increasing while death due to COPD was progressively decreasing over the period.Conclusion: COPD HC and admission number (particularly in female patients) decreased progressively from year 2006 to 2014. There was also a decreasing trend of severity of disease as reflected by lower NIV use (after year 2010) and lower mortality rate due to COPD. Reduced smoking prevalence and tuberculosis (TB) notification rate in the community in the past might have reduced the incidence and severity of COPD and the hospital burden of disease. We observed an increasing trend of mortality due to pneumonia in COPD patients. Appropriate and timely vaccination programs are recommended for COPD patients as in the general elderly population.Keywords: hospital burden, mortality, smoking, old tuberculosis, pneumonia
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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 | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.004 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 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".