title: Trends in COPD mortality and hospitalizations in countries and regions of Asia-Pacific.
abstract: OBJECTIVE
  The growing burden of COPD in the Asia-Pacific region supports the need for more intensive research and analysis of the epidemiology of COPD to raise awareness of the disease and its causes, to ensure the development of effective national health policies and to facilitate equitable deployment of finite health-care resources in the prevention and management of COPD. This study estimated and compared COPD mortality and hospital morbidity rates and trends in these rates over time across countries and regions of Asia-Pacific.
  
  
  METHODS
  Data consistent with standard definitions of COPD (ICD-9/ICD-10) for the period 1991-2004 were obtained from national health statistics agencies. For countries/regions with complete national mortality and hospitalization data (Australia, Pacific Canada (British Columbia, Hong Kong, South Korea and Taiwan), annual age-standardized mortality and hospitalization rates were calculated for men and women aged >or= 40 years. Negative binomial regression modelling was used to estimate rate ratios for country/region, gender and age differences and general trends over time.
  
  
  RESULTS
  Mortality rates per 10,000 population ranged 6.4-9.2 in men, 2.1-3.5 in women and 3.7-5.3 overall in 2003. Corresponding ranges for morbidity were 32.6-334.7, 21.2-129 and 28.1-207.3 per 10 000. Trend analysis of data since 1997 produced annual percentage changes in mortality versus hospitalization of -4.4% versus -0.7% in Australia, -3.6% versus 7.5% in Pacific Canada (British Columbia), -7.15% versus -5.6% in Hong Kong and -2.9% versus -4.2% in Taiwan.
  
  
  CONCLUSIONS
  In Asia-Pacific, overall mortality and morbidity rates are high and trends in mortality and morbidity vary between countries/regions. Differences in rates and trends for men and women most likely reflect the different trends in historical and prevalent smoking profiles for COPD in the different countries and regions.
authors.affiliation: UBC James Hogg iCapture Centre, St Paul's Hospital, Vancouver, Canada. wtan@mrl.ubc.ca
authors.forename: Wan C
authors.initials: WC
authors.lastname: Tan
authors.forename: Paul
authors.initials: P
authors.lastname: Seale
authors.forename: Mary
authors.initials: M
authors.lastname: Ip
authors.forename: Young-Soo
authors.initials: YS
authors.lastname: Shim
authors.forename: Chi-Huei
authors.initials: CH
authors.lastname: Chiang
authors.forename: Tze-Pin
authors.initials: TP
authors.lastname: Ng
authors.forename: John
authors.initials: J
authors.lastname: Abisheganadan
authors.forename: Suchai
authors.initials: S
authors.lastname: Charoenratanakul
authors.forename: Teresita
authors.initials: T
authors.lastname: DeGuia
authors.forename: Aziah
authors.initials: A
authors.lastname: Mahayiddin
authors.forename: Hardiato
authors.initials: H
authors.lastname: Mangunnegoro
authors.forename: Yong-Jian
authors.initials: YJ
authors.lastname: Xu
authors.forename: Nan-Shan
authors.initials: NS
authors.lastname: Zhong
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001208:Asia / Q000453:epidemiology; D001315:Australia / Q000453:epidemiology; D001955:British Columbia / Q000453:epidemiology; D005260:Female; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology / Q000401:mortality*; D012044:Regression Analysis; D017678:Sex Distribution