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

Abstract

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. Setting: The Finnish hospital discharge register. Subjects: The 72,672 inpatient episodes following emergency admissions of patients aged over 44 years that ended in 1993-2001 and had COPD as the principal diagnosis. Results: The mean duration of inpatient episodes was 8.5 days (SD 8.2) in 1993, but 6.8 days (SD 6.6) in 2001. The figure for 45- to 64-year-old men was 6.5 days (SD 6.6) and that for men aged >64 years, 7.8 days (SD 6.8). The corresponding figures for women were 7.1 days (SD 6.8) and 8.8 days (SD 8.4). The average interval between the end of one inpatient episode and the beginning of the next was 195.4 days (SD 327.7). This interval was longest when the inpatient episode lasted for 7 days (interval 215 days). Conclusions: The length of hospital stay for COPD exacerbation seems to be decreasing, and elderly women have the longest inpatient episodes. With the current treatment modalities, a 1-week stay in hospital results in the longest interval to readmission. The situation may change if supported home care at exacerbation can be increased. © British Geriatrics Society 2004; all rights reserved.