Data linkage provides clearer picture of COPD prevalence

3 minute read

But the data collected by the AIHW excludes undiagnosed and milder cases of COPD, as well as indigenous health services.

Data collected across different health services may offer a better understanding on chronic obstructive pulmonary disease (COPD) in Australia, a recent report from the AIHW has revealed.

The usage of service that treat those with COPD was captured in the National Integrated Health Services Information Analysis Asset (NIHSI AA), a data source collated by the AIHW.

Currently, data around COPD prevalence is primarily collected through surveys which are “time-consuming and expensive to collect, preventing annual updates”.

On the other hand, data collected in the NIHSI AA is a “cost-effective and updatable approach to produce ongoing population level estimates of COPD prevalence based on health service use”, the report stated.

It included data collected from hospitalisations in private and public hospitals, ED and outpatient services in public hospitals, the MBS, the PBS, the National Death Index, and residential aged care services.

A health consumer was identified as having COPD if they were hospitalised once or more with a “principal or additional diagnosis of COPD”, were dispensed with “two or more prescriptions for medicines to treat COPD” or presented twice at the emergency department with “a principal or additional diagnosis of COPD”.

Data from hospitalisations and ED presentations in the NT and WA were not available, but this “had limited effect on national level estimates”.

But the data collected from the NIHSI AA is somewhat limited as it primarily provides insights into those strongly affected by COPD.

The report acknowledges that undiagnosed COPD was not captured, and that milder cases of COPD were less likely to be identified as patients were “less likely to be dispensed COPD-specific medications or require emergency treatment”.

Further, as the existence of COPD was measured through the reported access of health services, groups including First Nations Australians and prisoners were excluded from the data. Data from the access of medicines from indigenous health services could not be associated with an individual and were excluded from the findings. 

The analysis of NIHSI AA data found that 270 people per every 10,000 aged 35 or older were taking medication or using emergency or hospital services for COPD between 1 July 2018 and 30 June 2019. From the ages of 35-64, the prevalence between sexes was similar, but COPD was more common among men older than 65.

Additionally, once adjusted for age, the prevalence of COPD in inner regional areas, and outer regional, remote, and very remote areas was 1.3 times higher than major cities.

The prevalence of COPD identified from NIHSI data was about 30% lower than estimates collected as part of the BOLD Australia study, which focused on clinical assessment and results of spirometry testing.The discrepancy was attributed to the fact that NIHSI did not account for undiagnosed or mild cases of COPD, or those with self-reported symptoms who were not hospitalised or did not access COPD-specific prescriptions.

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