Hospital at home services for acute exacerbation of chronic obstructive pulmonary disease: a survey of British practice.
OBJECTIVE
To identify the prevalence of and attitudes towards hospital at home services for acute exacerbation of chronic obstructive pulmonary disease (COPD) in Great Britain. To identify the models of service in existence, in particular staff numbers and the workload experienced.


METHODS
A postal survey was used to locate existing schemes. Telephone interviews were conducted with each of the hospital at home services identified.


METHODS
A questionnaire was sent to one consultant in each of 223 respiratory departments in Great Britain. Thirty six departments were subsequently contacted by telephone.


METHODS
Awareness and prevalence of hospital at home services. Perceived problems with starting a service. Details of organisation of existing services.


RESULTS
We received 186 replies to the postal questionnaire. Of these respiratory departments, 179 (96%) were aware of hospital at home services for acute exacerbation of COPD and, in November 1999, 30 (16%) were running such a service. Difficulty in obtaining funding was the main reason for not setting up a service rather than lack of evidence of benefit or unsuitability of local circumstances. Median staffing level was two nurses (range one to six) looking after a median number of new patients of five per week (range 0.5 to 12). There was wide variation in the organisation of services.


CONCLUSIONS
Despite lack of objective evidence of effectiveness, there was a high level of awareness of and interest in starting hospital at home services for acute exacerbation of COPD in British respiratory departments when assessed in November 1999.
Johnson
M K
MK
Department of Respiratory Medicine, Glasgow Royal Infirmary, 16 Alexandra Parade, Glasgow.
Flanigan
U
U
Fuld
J
J
Irwin
A
A
Stewart
C
C
Stevenson
R D
RD
D000208:Acute Disease; D001291:Attitude of Health Personnel; D001364:Awareness; D019538:Health Care Surveys; D018575:Home Care Services, Hospital-Based / Q000706:statistics & numerical data* / Q000600:supply & distribution*; D006801:Humans; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy*; D012139:Respiratory Therapy Department, Hospital / Q000706:statistics & numerical data*; D012606:Scotland; D011795:Surveys and Questionnaires; D006113:United Kingdom