title: Quantifying comorbidity in individuals with COPD: a population study.
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.
authors.affiliation: Sunnybrook Health Sciences Centre, Toronto, ON, Canada Institute for Clinical Evaluative Sciences, Toronto, ON, Canada University of Toronto, Toronto, ON, Canada The Hospital for Sick Children, Toronto, ON, Canada andrea.gershon@ices.on.ca.
authors.forename: Andrea S
authors.initials: AS
authors.lastname: Gershon
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.
authors.forename: Graham C
authors.initials: GC
authors.lastname: Mecredy
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.
authors.forename: Jun
authors.initials: J
authors.lastname: Guan
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto, ON, Canada University of Toronto, Toronto, ON, Canada.
authors.forename: J Charles
authors.initials: JC
authors.lastname: Victor
authors.affiliation: University of Toronto, Toronto, ON, Canada Westpark Healthcare Centre, Toronto, ON, Canada.
authors.forename: Roger
authors.initials: R
authors.lastname: Goldstein
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto, ON, Canada University of Toronto, Toronto, ON, Canada The Hospital for Sick Children, Toronto, ON, Canada.
authors.forename: Teresa
authors.initials: T
authors.lastname: To
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000150:complications; D015897:Comorbidity; D048909:Diabetes Complications / Q000473:pathology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008175:Lung Neoplasms / Q000150:complications; D008297:Male; D001523:Mental Disorders / Q000150:complications; D008875:Middle Aged; D015233:Models, Statistical; D009140:Musculoskeletal Diseases / Q000150:complications; D009369:Neoplasms / Q000150:complications; D009864:Ontario; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology*; D012141:Respiratory Tract Infections / Q000150:complications; D012307:Risk Factors; D012680:Sensitivity and Specificity