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Peer-reviewedCC BYPublic health challenges

Health-Care Burden of Acute Exacerbation of Chronic Obstructive Pulmonary Disease in Hong Kong in the Post-COVID Pandemic Era-Impact of Phenotype and Exacerbation History.

4 affiliations
  1. 1Division of Respiratory Medicine Department of Medicine School of Clinical Medicine LKS Faculty of Medicine The University of Hong Kong Hong Kong SAR China.
  2. 2Division of Cardiology Department of Medicine School of Clinical Medicine LKS Faculty of Medicine The University of Hong Kong Hong Kong SAR China.
  3. 3Department of Statistics University of South Carolina Columbia South Carolina USA.
  4. 4Department of Statistics The Chinese University of Hong Kong, Shatin, New Territories Hong Kong SAR China.

Abstract

Rationale

Chronic obstructive pulmonary disease (COPD) is known to be associated with substantial health-care utilization and economic costs. Since the COVID-19 pandemic, the epidemiology of various diseases has undergone significant changes, it is important to evaluate the health-care impact and economic burden of acute exacerbations of COPD (AECOPD) in the post-pandemic period, along with factors influencing this burden, to inform effective management strategies and health-care planning.Objectives

To assess the health-care and economic burden of severe AECOPD from 2022 to 2024, and to identify factors associated with direct health-care costs.Methods

A territory-wide retrospective cohort study was conducted. Adult patients with AECOPD admitted to acute public hospitals in Hong Kong were included. The primary outcomes were the total number of AECOPD admissions and the associated direct health-care costs.Measurements and main results

From 2022 to 2024, a total of 11,465 patients were admitted to acute public hospitals for severe AECOPD, resulting in 25,053 hospitalization episodes and 150,717 bed days. The estimated direct health-care costs totaled 1.259 billion Hong Kong dollars (HKD). AECOPD admission numbers increased significantly over the 3 years. Patients with eosinophilic and non-eosinophilic phenotypes had similar annual direct health-care costs related to severe AECOPD. Patients with co-existing bronchiectasis had a significantly higher annual number of severe AECOPD episodes and direct health-care costs from severe AECOPD.Conclusions

Severe AECOPD imposes a substantial burden on the health-care system. The presence of bronchiectasis and a greater frequency of severe AECOPD episodes were identified as possible factors linked to increased direct health-care costs.

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BibTeX
@article{kwok2026healthcare,
  title = {{Health-Care Burden of Acute Exacerbation of Chronic Obstructive Pulmonary Disease in Hong Kong in the Post-COVID Pandemic Era-Impact of Phenotype and Exacerbation History.}},
  author = {Wang Chun Kwok and Ali Choo and Lu Zhou and Ting Fung Ma and Isaac Sze Him Leung and Chun Ka Wong and James Chung Man Ho},
  journal = {Public health challenges},
  year = {2026},
  month = oct,
  doi = {10.1002/puh2.70425},
  url = {https://europepmc.org/article/MED/42948801},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Health-Care Burden of Acute Exacerbation of Chronic Obstructive Pulmonary Disease in Hong Kong in the Post-COVID Pandemic Era-Impact of Phenotype and Exacerbation History.
AU  - Wang Chun Kwok
AU  - Ali Choo
AU  - Lu Zhou
AU  - Ting Fung Ma
AU  - Isaac Sze Him Leung
AU  - Chun Ka Wong
AU  - James Chung Man Ho
PY  - 2026
DA  - 2026/10/27
JO  - Public health challenges
DO  - 10.1002/puh2.70425
UR  - https://europepmc.org/article/MED/42948801
AB  - Rationale  Chronic obstructive pulmonary disease (COPD) is known to be associated with substantial health-care utilization and economic costs. Since the COVID-19 pandemic, the epidemiology of various diseases has undergone significant changes, it is important to evaluate the health-care impact and economic burden of acute exacerbations of COPD (AECOPD) in the post-pandemic period, along with factors influencing this burden, to inform effective management strategies and health-care planning.Objectives  To assess the health-care and economic burden of severe AECOPD from 2022 to 2024, and to identify factors associated with direct health-care costs.Methods  A territory-wide retrospective cohort study was conducted. Adult patients with AECOPD admitted to acute public hospitals in Hong Kong were included. The primary outcomes were the total number of AECOPD admissions and the associated direct health-care costs.Measurements and main results  From 2022 to 2024, a total of 11,465 patients were admitted to acute public hospitals for severe AECOPD, resulting in 25,053 hospitalization episodes and 150,717 bed days. The estimated direct health-care costs totaled 1.259 billion Hong Kong dollars (HKD). AECOPD admission numbers increased significantly over the 3 years. Patients with eosinophilic and non-eosinophilic phenotypes had similar annual direct health-care costs related to severe AECOPD. Patients with co-existing bronchiectasis had a significantly higher annual number of severe AECOPD episodes and direct health-care costs from severe AECOPD.Conclusions  Severe AECOPD imposes a substantial burden on the health-care system. The presence of bronchiectasis and a greater frequency of severe AECOPD episodes were identified as possible factors linked to increased direct health-care costs.
SN  - 2769-2450
ER  -