Scientific Reports (Dec 2023)

Decreasing COPD-related incidences and hospital admissions in a German health insurance population

  • Siegfried Geyer,
  • Juliane Tetzlaff,
  • Stefanie Sperlich,
  • Batoul Safieddine,
  • Jelena Epping,
  • Sveja Eberhard,
  • Jona Stahmeyer,
  • Johannes Beller

DOI
https://doi.org/10.1038/s41598-023-48554-y
Journal volume & issue
Vol. 13, no. 1
pp. 1 – 11

Abstract

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Abstract Chronic obstructive pulmonary disease (COPD) is associated with smoking and work-related health hazards. Most studies have reported prevalences, and the number of studies examining incidences and social inequalities is small. We analyzed the development of social inequalities of COPD-incidences in terms of income and exacerbations in terms of hospital admissions. Findings were based on claims data from a German statutory health insurance covering 2008 to 2019. Outpatient diagnoses were used for defining COPD-cases, hospital admissions were used for detecting exacerbations. Analyses were performed using Cox-regression. Individual incomes were depicted at three levels defined according to national averages for each year. Data of 3,040,137 insured men and women were available. From 2008 to 2019 COPD-incidences in men decreased by 42% and 47% in women. After stratification by income the reduction at the lowest income level was 41% and 50% in women. Respectively, at the highest income level reductions were 28% and 41%. Disease exacerbations decreased over time, and also social inequalities between income groups emerged. COPD-rates decreased over time at all income levels, but at a faster pace in the lowest income group, thus leading to a positive development of diminishing social gradients in men as well as in women.