Chronic obstructive pulmonary disease (COPD): secondary care data

Statistics on hospital discharges for COPD are held in the Scottish Morbidity Record (SMR01) database, which also includes linked data on deaths. Chart 1 shows the incidence of COPD in Scotland by sex from 2002/03 to 2021/22. Incidence refers to the number of new cases in a population during a period of time and is defined here as first admission or death due to COPD (based on a 10 year incidence look back period). The figures in Chart 1 have been directly age standardised using the 2013 European standard population. Chart 1 shows a sharp decrease in the 2020/21 rates compared to those in previous years. The COVID-19 pandemic has caused significant changes to the provision of healthcare services, and has had an impact on individuals’ health and their use of healthcare services. Therefore, this data should be interpreted with caution.  In 2021/22 COPD rates have started to increase as the impact of COVID-19 eased. The rate in males increased from 83.2 to 97.6 cases per 100,000, and for females the increase was from 72.6 to 97.3.  However, they are still significantly lower than the pre-pandemic rates (around 134 for males and females).  Over the last ten years rates have fluctuated, with males and females generally following a similar pattern. Recent figures show that the female incidence of COPD is now similar to that of males, where in the earliest years shown the rate in males was much higher.

The increase in incidence in women is apparent despite falling smoking rates (see Smoking Data section) and is consistent with the well described lag of smoking related diseases behind changes in the rate of smoking (Lopez, 1994). Patterns of COPD over time can be understood more clearly by examining incidence rates in different age groups. Chart 2 shows the incidence by sex and age, with most groups showing a slight increase. In the oldest age group incidence was higher in men than women, reflecting the much higher smoking rates in men than women when these people were younger. The opposite pattern was seen in the youngest age group, with incidence generally higher in women, again reflecting more recent rises in female smoking. In the intermediate age group (those aged 65 to 84 years), incidence in women was initially lower than in men but by 2010/11 was similar and at times has been higher.

More information on COPD incidence can be found in the ScotPHO profiles tool.