[Quality of inpatient care and risk of early readmission in acute exacerbation of COPD].
BACKGROUND
Chronic Obstructive Pulmonary Disease (COPD) is one of the diseases that causes more readmissions in our hospitals. The objective of our study was to establish the influence of quality of inpatient care on the risk of early readmission in the acute exacerbation of COPD.


METHODS



METHODS
case and controls study.


METHODS
general acute care hospital.


METHODS
random sample of admissions with acute exacerbation of COPD and discharged alive.


METHODS
patients who were readmitted within 30 days with a related diagnosis.


METHODS
patients who were not readmitted and finished alive the mentioned period.


METHODS
audit of clinical charts with evaluation of clinical severity and adherence to explicit criteria of quality of inpatient care in OCFA. Bivariate and multivariate logistic regression (LR) analysis.


RESULTS
45 cases and 45 controls were analyzed. LR model detected the risk of readmission within 1 month was explained by the higher severity of patients (Apache III: OR 1,03) and their principal diagnosis(emphysema: OR 6,9 and bronchiectasias: OR 2,2, respect to chronic bronchitis). The less score of quality of care scale was predictive of the risk of readmission in the subgroup of patients who were readmitted within 1 week (OR 0,9).


CONCLUSIONS
Risk of readmission within 1 month in the acute exacerbation of COPD were explained mainly by the clinical characteristics of patients. Otherwise, readmissions within 1 week were related to quality of care, so it could be a valid indicator of quality of inpatient care.
Jiménez Puente
A
A
Dirección de Sistemas de Información. Hospital Costa del Sol. Málaga, Spain. ajpuente@hcs.es
Fernández Guerra
J
J
Hidalgo Rojas
L
L
Domingo González
S
S
Lara Blanquer
A
A
García Alegría
J
J
D018806:APACHE; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D010351:Patient Discharge; D010359:Patient Readmission / Q000706:statistics & numerical data; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology / Q000628:therapy*; D011787:Quality of Health Care; D012008:Recurrence