An association between length of stay and co-morbidity in chronic airflow limitation.
OBJECTIVE
To examine factors which impact on the length of stay and readmission for patients with chronic airflow limitation at a South Australian hospital from December 1996 until March 1998.


METHODS
Discharges from Flinders Medical Centre for patients aged > or = 18 years, where chronic airflow limitation was an active problem, and including a subset with a primary diagnosis of chronic airflow limitation, were identified, retrospectively, by the center's Clinical Coding Service from the hospital's in-patient separation database.


METHODS
Flinders Medical Centre, Adelaide, South Australia.


METHODS
Length of stay; number of co-morbidities; readmission within 28 days.


RESULTS
Five-hundred and twenty discharges (male:female, 258:262) with a primary diagnosis of chronic airflow limitation (ANDRG-3 177, chronic obstructive airways disease) were identified. Readmission within 28 days was related to the number of co-morbidities and to age. A relationship between length of stay and the number of co-morbidities was identified. A mean length of stay of 6.39 days was found for patients with less than five co-morbidities, 5.36 at their first admission to Flinders Medical Centre and 3.25 at their first admission to Flinders Medical Centre with no co-morbidities. These mean lengths of stay fall below overseas data previously published and are consistent with Kong's estimate of an ideal mean length of stay of 3.2 days when a clinical management guideline is used in low-risk chronic airflow limitation patients.


CONCLUSIONS
Length of stay and readmission to hospital within 28 days of patients with a primary diagnosis of chronic airflow limitation is at least partly related to the number of co-morbidities and to age. The study has highlighted the difficulty of relying on changes to aggregate data as outcome measures for these patients.
Crockett
A J
AJ
Respiratory Unit, Flinders Medical Centre and Flinders University, Bedford Park, South Australia. alan.crockett@flinders.edu.au
Cranston
J M
JM
Moss
J R
JR
Alpers
J H
JH
D000328:Adult; D015897:Comorbidity; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008173:Lung Diseases, Obstructive / Q000150:complications*; D017063:Outcome Assessment, Health Care; D010351:Patient Discharge / Q000706:statistics & numerical data; D010359:Patient Readmission; D013021:South Australia