Projecting the 20-year healthcare resource burden of asthma and COPD multimorbidity: insights from Singapore for integrated chronic respiratory care in South-East Asia.

IF 4.7 3区医学 Q1 PRIMARY HEALTH CARE

NPJ Primary Care Respiratory Medicine Pub Date : 2026-04-09 DOI:10.1038/s41533-026-00502-9

Yah Ru Juang, Laura Huey Mien Lim, Sanjay H Chotirmall, Kelvin Bryan Tan, Mariko Siyue Koh, John A Abisheganaden, David B Price, Ming-Ju Tsai, Mei Fong Liew, Pei Yee Tiew, Anthony Chau Ang Yii, Wenjia Chen

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引用次数: 0

Abstract

Background: Asthma and chronic obstructive pulmonary disease (COPD) incur significant comorbidity and healthcare burden. However, their future economic burden remain unclear.

Objective: To project 20-year (2024-2043) asthma and COPD multimorbidity costs in Singapore, illustrating broader Southeast Asian trends.

Methods: Patients with asthma (all ages) or COPD ( $\geq$ 40 years) were identified from Singapore's health administrative data (2002-2019). Age- and sex-specific, disease-specific per-episode costs and annual healthcare utilisation rates (hospitalisation, emergency department, and outpatient) were estimated using generalised linear models and projected using change-point analysis. Population-level costs were projected using a probabilistic simulation model incorporating population forecasts. Costs were reported in 2023 Singaporean dollars (SGD$1 = US$0.76 = ₤0.60 = €0.69).

Results: Asthma cases are projected to triple from 64,338 in 2019 to 192,409 by 2043 (95% confidence interval [CI]: 165,493-225,141), incurring $7.8 billion (95% CI: 4.4-17.1) from 2024-2043. Apart from asthma (16.4%), costs are driven by metabolic (20.0%), circulatory (14.3%), and other respiratory (9.2%) diseases, with children bearing the highest burden (girls: 39.9%; boys: 22.6%). COPD cases would grow from 8,988 in 2019 to 11,038 (95% CI: 8395-13,326) in 2043, incurring $2.4 billion (95% CI: 1.6-4.5) from 2024-2043. Apart from COPD (20.3%), metabolic (17.4%), circulatory (17.0%), and other respiratory diseases (9.8%) are the largest cost components, with elderly and adult males bearing the highest burdens (47.8% and 40.1%). In both cohorts, 20-year projected costs are dominated by outpatient (55%) and hospitalisation costs (30-40%).

Conclusion: The 20-year multimorbidity costs of asthma and COPD are significant, especially in cardiometabolic comorbidities, underscoring the need for holistic, value-based care.

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预测20年哮喘和慢性阻塞性肺病多发病的医疗资源负担：新加坡对东南亚综合慢性呼吸系统护理的见解。

背景：哮喘和慢性阻塞性肺疾病（COPD）会产生显著的合并症和医疗负担。然而，他们未来的经济负担仍不明朗。目的：预测新加坡20年（2024-2043）哮喘和慢性阻塞性肺病多病成本，说明更广泛的东南亚趋势。方法：从新加坡卫生行政数据（2002-2019）中确定哮喘（所有年龄）或COPD（≥40岁）患者。使用广义线性模型估计年龄和性别、疾病特异性每次发作成本和年度医疗保健利用率（住院、急诊和门诊），并使用变化点分析进行预测。使用包含人口预测的概率模拟模型来预测人口水平的成本。成本报告以2023年新加坡元计算（1新元= 0.76美元= 0.60英镑= 0.69欧元）。结果：哮喘病例预计将从2019年的64,338例增加到2043年的192,409例（95%置信区间[CI]: 165,493-225,141）， 2024-2043年将产生78亿美元（95% CI: 4.4-17.1）。除哮喘（16.4%）外，代谢性疾病（20.0%）、循环系统疾病（14.3%）和其他呼吸系统疾病（9.2%）也是造成费用增加的原因，其中儿童负担最重（女孩：39.9%；男孩：22.6%）。COPD病例将从2019年的8988例增加到2043年的11038例（95% CI: 8395- 13326）， 2024-2043年将产生24亿美元（95% CI: 1.6-4.5）。除COPD（20.3%）外，代谢（17.4%）、循环（17.0%）和其他呼吸系统疾病（9.8%）是最大的成本组成部分，老年人和成年男性负担最高（47.8%和40.1%）。在这两个队列中，20年的预计费用主要是门诊费用（55%）和住院费用（30-40%）。结论：哮喘和慢性阻塞性肺病的20年多病成本是显著的，特别是在心脏代谢合并症中，强调需要全面的、基于价值的护理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

NPJ Primary Care Respiratory Medicine PRIMARY HEALTH CARE-RESPIRATORY SYSTEM

CiteScore

5.50

自引率

6.50%

发文量

审稿时长

10 weeks

期刊介绍： npj Primary Care Respiratory Medicine is an open access, online-only, multidisciplinary journal dedicated to publishing high-quality research in all areas of the primary care management of respiratory and respiratory-related allergic diseases. Papers published by the journal represent important advances of significance to specialists within the fields of primary care and respiratory medicine. We are particularly interested in receiving papers in relation to the following aspects of respiratory medicine, respiratory-related allergic diseases and tobacco control: epidemiology prevention clinical care service delivery and organisation of healthcare (including implementation science) global health.