Differences in severe exacerbations rates and health care utilisation in COPD populations in the UK and France
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Introduction
Chronic obstructive pulmonary disease (COPD) is a leading cause of mortality in Europe; however, it is important to understand how clinical practice patterns differ between countries and how this might relate to disease outcomes, to identify ways of improving local disease management. We aimed to describe and compare the management of COPD patients in the UK and France between 2008 and 2017.
Methods
We used data from the Clinical Practice Research Datalink GOLD and Hospital Episode Statistics in the UK and the Echantillon Généraliste des Bénéficiaire in France to identify COPD patients each year between 2008 and 2017. We compared patient characteristics, all-cause mortality, and COPD exacerbations each year between 2008 and 2017 for patients in the UK and France separately. Health care utilisation and COPD exacerbations in 2017 were compared between France and the UK using t-tests and chi-squared tests.
Results
COPD patients were similar in gender and comorbidities in both countries. In the UK, incidence of COPD exacerbations remained stable in the UK and France between 2007-2017. In 2017, the proportion of all-cause and COPD-related hospitalisations was greater in the UK than in France (43.9% vs. 32.8% and 8.3% vs 4.9%, respectively; p<0.001) as was the proportion of patients visiting accident and emergency (39.8% vs 16.2%, respectively; p<0.001). In addition, the mean length of stay in hospital for COPD related causes was shorted in the UK than in France (6.2 days (SD 8.4) vs 10.5 days (SD 9.1), respectively; p<0.001).
Discussion
Overall, UK patients were more likely to go to accident and emergency (A&E) and be hospitalised for COPD-related causes and stay in hospital for fewer days after being admitted for COPD-related reasons compared to patients in France, illustrating a difference in health-seeking behaviours and access to healthcare.
Chronic obstructive pulmonary disease (COPD) is a leading cause of mortality in Europe; however, it is important to understand how clinical practice patterns differ between countries and how this might relate to disease outcomes, to identify ways of improving local disease management. We aimed to describe and compare the management of COPD patients in the UK and France between 2008 and 2017.
Methods
We used data from the Clinical Practice Research Datalink GOLD and Hospital Episode Statistics in the UK and the Echantillon Généraliste des Bénéficiaire in France to identify COPD patients each year between 2008 and 2017. We compared patient characteristics, all-cause mortality, and COPD exacerbations each year between 2008 and 2017 for patients in the UK and France separately. Health care utilisation and COPD exacerbations in 2017 were compared between France and the UK using t-tests and chi-squared tests.
Results
COPD patients were similar in gender and comorbidities in both countries. In the UK, incidence of COPD exacerbations remained stable in the UK and France between 2007-2017. In 2017, the proportion of all-cause and COPD-related hospitalisations was greater in the UK than in France (43.9% vs. 32.8% and 8.3% vs 4.9%, respectively; p<0.001) as was the proportion of patients visiting accident and emergency (39.8% vs 16.2%, respectively; p<0.001). In addition, the mean length of stay in hospital for COPD related causes was shorted in the UK than in France (6.2 days (SD 8.4) vs 10.5 days (SD 9.1), respectively; p<0.001).
Discussion
Overall, UK patients were more likely to go to accident and emergency (A&E) and be hospitalised for COPD-related causes and stay in hospital for fewer days after being admitted for COPD-related reasons compared to patients in France, illustrating a difference in health-seeking behaviours and access to healthcare.
Date Issued
2022-08-09
Date Acceptance
2022-07-31
Citation
BMJ Open, 2022, 9 (1)
ISSN
2044-6055
Publisher
BMJ Journals
Journal / Book Title
BMJ Open
Volume
9
Issue
1
Copyright Statement
© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
License URL
Subjects
COPD epidemiology
Publication Status
Published
Article Number
ARTN e001150
Date Publish Online
2022-08-09