title: The effect of a post acute respiratory outreach service for patients with chronic obstructive pulmonary disease on hospital readmission rates.
abstract: OBJECTIVE
  The aim of this study was to investigate the effect of a Post Acute Respiratory Outreach Service (PAROS) for patients with chronic obstructive pulmonary disease (COPD), on hospital utilization.
  
  
  METHODS
  A retrospective cohort of patients was examined, using a nested comparison, to test the hypothesis that PAROS would affect hospital utilization in the 12 months following the intervention. Patients admitted with COPD and subsequently enrolled in PAROS were compared with age, sex and diagnosis-matched controls admitted with COPD, who did not receive PAROS.
  
  
  RESULTS
  Of 216 patients admitted with COPD during the 1-year study period, 28 were referred to PAROS. A total of 25 suitable controls were identified. Three cases that could not be matched were excluded from the analysis. There were no significant differences in lung function or prior hospitalization between the two groups at baseline. A significant increase in hospital bed days, in the 12 months following the index admission, was observed in the PAROS group (P = 0.046). There was no difference in the number of admissions or emergency department presentations between the groups.
  
  
  CONCLUSIONS
  The PAROS program did not lead to a reduction in hospital utilization. This study supports previous findings that respiratory outreach services delivered immediately post discharge increase hospital utilization.
authors.affiliation: The Northern Clinical Research Centre, The Northern Hospital, Northern Health, Melbourne, Australia. kim.jeffs@nh.org.au
authors.forename: Kimberley J
authors.initials: KJ
authors.lastname: Jeffs
authors.forename: Wen K
authors.initials: WK
authors.lastname: Lim
authors.forename: Michael
authors.initials: M
authors.lastname: Lim
authors.forename: David J
authors.initials: DJ
authors.lastname: Berlowitz
authors.forename: Bruce
authors.initials: B
authors.lastname: Jackson
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D003159:Community-Institutional Relations; D005260:Female; D006699:Home Care Services / Q000706:statistics & numerical data; D015285:Hospital-Patient Relations; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods* / Q000458:organization & administration; D010359:Patient Readmission / Q000706:statistics & numerical data*; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy*; D012189:Retrospective Studies; D013997:Time Factors