Smoking makes asthma expensive: a register-based study in Finland.

Setting: Chronic bronchitis and chronic obstructive pulmonary disease (COPD)/emphysema occur frequently among middle-aged and elderly asthma patients who smoke.

Objective: To test how much this comorbidity increases the use and costs of health services in comparison with asthma alone.

Design: A sample of 6000 adults with a clinical diagnosis of asthma was extracted from a nationwide health insurance register for a postal inquiry.

Trends in hospitalization for childhood asthma in Finland in 1996-2004.

Aim: To discuss trends based on data on all asthma-related admissions of children under 15 years of age.

Methods: retrospective analysis of records of the Finnish National Research and Development Centre for Welfare and Health in 1996-2004. The analysis was stratified for age.

What lies behind relief and worsening of asthma symptoms? A register-based study of adults with asthma and other chronic obstructive pulmonary diseases in Finland.

Aims: To examine how subjects with relief or worsening of asthma symptoms differ in terms of gender, age, severity and duration of asthma, comorbidity, and difficulties with medication and daily life.

Methods: A postal inquiry among a sample of 6000 adults with clinically diagnosed asthma and/or other chronic obstructive pulmonary diseases.

Results: Relief of asthma symptoms over a 12-month period was associated with a recent asthma diagnosis, within five years, in both sexes.

Comorbidity and medication load in adult asthmatics.

Objective: To examine comorbidity and the medication load among asthmatics. Design A self-administered postal inquiry.

Setting: A national register-based random sample of 6000 subjects aged 16 years or older entitled to special reimbursement for anti-asthmatic medication in Finland.

Achievements and shortcomings of Finnish asthma care.

Background: The Finnish National Asthma Programme was launched in 1994.

Aim: A postal self-completion questionnaire study was undertaken to evaluate how the guideline is working in the Finnish healthcare system.

Methods: A postal inquiry was sent to a random sample of 6,000 subjects aged 16+ years who were entitled to special reimbursement for anti-asthmatic medication and 4,657 subjects with self-reported asthma were included.

Length of stay and interval to readmission in emergency hospital treatment of COPD.

Background: increasing attention has recently been attached to the length of hospital stay and related factors in the treatment of COPD.

Objectives: to assess the trend in the duration of inpatient episodes following emergency admissions for COPD by age and sex, and the frequency of readmissions, as well as the correlations between the frequency and duration of inpatient episodes.

Design: retrospective study.

Impact of comorbidities on the duration of COPD patients' hospital episodes.

The duration of inpatient episodes due to COPD and the factors that affect it have recently been an object of increasing attention, as the aim has been to shorten inpatient periods and thereby to cut health-care costs. All hospital episodes of patients aged over 45 for a primary diagnosis of COPD equal or less than 150 days in duration were drawn from the treatment register maintained by the National Research and Development Centre for Welfare and Health. The lengths of these 152569 inpatient periods were analysed for sex, age and secondary diagnoses by covariance analysis.

Regional and seasonal variation in the length of hospital stay for chronic obstructive pulmonary disease in Finland.

Notable regional and seasonal variation has been reported in the rate of hospital admissions for chronic obstructive pulmonary disease (COPE). The aim of this study was to assess the variation in the length of hospital stay for COPD in Finland on the north south axis and by season. For this purpose, the patient records of subjects aged over 45 hospitalised altogether 153,401 times with COPD as their primary diagnosis during 1987 - 1998 were retrieved from the Finnish Hospital Discharge Register maintained by the National Research and Development Centre for Welfare and Health.

Seasonal fluctuations in hospitalisation for pneumonia in Finland.

The purpose of this paper is to describe seasonal fluctuations in hospitalisation for pneumonia in Finland over the period 1972-1993. Treatment periods with pneumonia as the main or secondary diagnosis were collected from the national hospital discharge register. The seasonality of monthly hospital admissions was analysed using the X11 ARIMA procedure.

Seasonal variations in hospital treatment periods and deaths among adult asthmatics.

The purpose of this study was to examine possible seasonal variations in relations between hospital treatment periods and in deaths (asthma-related and other) among adult asthmatics. Out of a total of 364,871 asthma-induced hospitalization periods (diagnosis No. 493, International Classification of Diseases) recorded in the hospital discharge register maintained by the National Research and Development Centre for Welfare and Health during 1972-1992, all of those applying to persons aged >24 yrs during 1987-1992 were analysed here.

The course of childhood bronchiectasis: a case report and considerations of hospital use.

This paper discusses the clinical history of a Finnish person from the area north of the Arctic Circle with childhood-onset bronchiectasis. It covers a period of 30 years and is aimed at analysing the significance of the disease for the use of hospital services. Childhood bronchiectasis is a rare disease nowadays and difficult to diagnose, but it still leads to serious disability in some children, requiring regular hospitalisation.

Evaluation of the incidence and age distribution of bronchiectasis from the Finnish hospital discharge register.

The incidence and age distribution of bronchiectasis is at present poorly known. The aim here was to describe the use made of hospital services by bronchiectasis patients in Finland over ten years and to estimate the incidence of this disease. Data on hospital admissions for bronchiectasis were obtained from the register maintained by the National Research and Development Centre for Welfare and Health.

Survival experience of the population needing hospital treatment for asthma or COPD at age 50-54 years.

The aim was to evaluate the differences of mortality among asthma and COPD patients on the basis of the first period of hospitalization of these diseases. A total of 576,916 treatment periods for asthma and COPD between 1972 and 1992 were identified in the discharge register maintained by the National Research and Development Centre for Welfare and Health. Patients aged 50-54 years first treated in hospital in 1977 or later were analysed.

Bronchiectasis: an orphan disease with a poorly-understood prognosis.

The prognosis and risk factors for bronchiectasis are at present poorly known. The aim of this study was to examine the long-term prognosis and cause of death in this disease. The National Hospital Discharge Register was used to search for patients aged 35-74 yrs, with newly-diagnosed bronchiectasis in the period 1982-1986.

Regional differences in long-term mortality among hospital-treated asthma and COPD patients.

Chronic obstructive pulmonary diseases, which have increased due to smoking and ageing of the population, constitute a national health problem, the treatment of which can be expected to arouse considerable discussion in health care organisations currently preoccupied with economic problems. Although extensive medication and easy access to treatment are often regarded as therapeutically desirable, it may be questioned whether they have any impact on objective measures such as mortality. International recommendations for the early treatment of asthma have met with satisfaction and the asthma situation can be said to be under control, even though occurrences tend to be on the increase.

Links between hospital diagnoses of bronchiectasis and asthma.

In view of the conflicting notions of the relationship between bronchiectasis and asthma, we have analysed the use of hospital services by bronchiectasis and asthma patients and evaluated the links between these diseases, employing data from the Finnish Hospital Discharge Register of over 21 million hospitalization periods recorded in 1972-92. We conclude that asthma is common in hospitalized bronchiectasis patients and appears to be consequent upon this disease.

Bronchiectasis in Finland: trends in hospital treatment.

The incidence of bronchiectasis has probably declined in developed countries in recent years, but no reliable statistical data on this are available. The present paper describes the use made of hospital services by bronchiectatic patients in Finland. Data on a total of 12,539 treatment periods for bronchiectasis that had occurred between 1972 and 1992 were collected from the discharge register maintained by the National Research and Development Centre for Welfare and Health (diagnosis 518 in the International Classification of Diseases up to 1986, and 494 from 1987 onwards).

Asthma-induced hospitalizations among conscripts in Finland in 1982-1992.

The purpose was to examine changes in the numbers of asthma-related hospitalizations among conscripts and possible seasonal fluctuations. Data on treatment periods for asthma among men aged 18-22 years at military hospitals in 1982-1992 were collected from the national hospital discharge register. Monthly numbers of hospitalizations were calculated for each year separately, together with the frequency of such periods per 1000 conscripts.

Seasonal variation in childhood asthma hospitalisations in Finland, 1972-1992.

Unlabelled: All hospital treatment periods caused by asthma in children under 15 years in Finland during 1972-1992 were examined. The data were obtained from the Hospital Discharge Register, covering all hospitalisations in Finland. A total of 59,624 asthma related treatment periods were recorded.

Survival and cause of death among elderly chronic obstructive pulmonary disease patients after first admission to hospital.

Those patients with chronic obstructive pulmonary disease (COPD) who require hospital treatment are severely ill. We have studied the survival and cause of death among COPD patients in Finland after their first admission to hospital due to COPD. COPD-related treatment periods in all hospitals during 1972-1992 were collected from the national discharge register, and a subgroup was defined consisting of 2,237 patients aged 65-69 years who had their first admission during 1986-1990.

Seasonal variation in hospital admissions for chronic obstructive pulmonary disease in Finland.

Background: Hospital admissions in general are characterised by a marked seasonal variation. We studied the periodicity in hospital treatment for chronic obstructive pulmonary disease (COPD) in Finland where the unfavourable climate with great climatic differences between summer and winter may play an important role in causing the seasonality in COPD hospitalisation.

Methods: Data by month were obtained for the years 1972-92 from the National Discharge Register, which contains information on patients treated in all hospitals in Finland.

Hospital admissions of asthmatics by age and sex.

Asthma-related hospital admissions and the occurrence of new admissions were studied by age and sex in order to find the groups of asthmatics with high hospital admission rates. Data from the Finnish discharge register for 1972-92 were used to analyze the number of hospital admissions caused by asthma (defined in the International Classification of Diseases, 8th and 9th revisions, code 493) and occurrence of new asthma admissions between 1983 and 1992. A total of 192195 asthma-induced treatment periods were identified, 91223 for males and 100972 for females.

Hospital admissions for chronic obstructive pulmonary disease in the population aged 55 years or over in Finland during 1972-1992.

Hospital admissions for patients with COPD (chronic obstructive pulmonary disease) as the primary diagnosis for the total Finnish population aged 55 years or over were collected from discharge register from 1972 to 1992. Numbers of admissions and days in hospital by sex and age in relation to total population and the duration of stay in hospital were analysed. A total of 188,570 admissions related to COPD were recorded.