The Projected Epidemic of COPD Hospitalizations Over the Next 15 Years: A Population Based Perspective

Chronic obstructive pulmonary disease (COPD) is a major source of morbidity, mortality, and costs in the Western world. In the United States, for example, COPD is responsible for $72 billion/yr in direct healthcare expenditures. The biggest driver of these healthcare costs is hospitalization. Unlike many other major causes of hospitalization, hospitalizations related to COPD continue to increase despite falling rates in cigarette smoking. It is projected that within 5 years, COPD hospitalizations will exceed those of ischemic heart disease, which is the current number one cause of medical hospitalization in the United States. In countries such as Canada, which have older demographics than the United States, COPD has already surpassed ischemic heart disease as the leading cause of hospitalization. Cigarette smoking is the single most important modifiable risk factor for COPD, but it has been postulated that population aging may counterbalance the beneficial effects of diminishing smoking rates on the burden of COPD in many countries.