Epidemiology and economic burden of bronchiectasis requiring hospitalisation in Singapore

Abstract

Background and objective: Little is known about the epidemiology and cost of bronchiectasis in Asia. This study describes the disease burden of bronchiectasis in Singapore.

Methods: A nationwide administrative dataset was used to identify hospitalisations with bronchiectasis as a diagnosis. Population statistics and medical encounter data were used to estimate the incidence, mortality, prevalence and direct medical costs associated with bronchiectasis requiring hospitalisation.

Results: There were 420 incident hospitalised bronchiectasis patients in 2017, giving an incidence rate of 10.6 per 100 000. Age-standardised incidence declined on average by 2.7% per year between 2007 and 2017. Incidence rates increased strongly with age in both men and women. Tuberculosis was a secondary diagnosis in 37.5% of incident hospitalisations in 2007, but has declined sharply since then. Patient survival was considerably lower in both men (5-year relative survival ratios (RSR) 0.63, 95% CI 0.59-0.66) and women (5-year RSR 0.75, 95% CI 0.72-0.78). The point prevalence of bronchiectasis was 147.1 per 100 000 in 2017, and increased sharply with age, with >1% of people aged ≥75 years having bronchiectasis. Total first-year costs among incident bronchiectasis patients in 2016 varied widely, with a mean±sd USD 7331±8863. Approximately 10% of the patients admitted in 2016 had total first-year costs of more than USD 14 380.

Conclusion: Bronchiectasis is common and imposes a substantial burden on healthcare costs and survival rates of patients in Singapore.

FIGURE 1

a) Age-standardised incidence of hospitalised bronchiectasis patients in Singapore by sex, 2007–2017; b) incidence of hospitalised bronchiectasis patients in Singapore by sex and age group, 2017.

FIGURE 2

Cumulative relative survival among incident hospitalised bronchiectasis patients in Singapore by sex and time from the first admission.