[Nurse-supported discharge of patients with exacerbation of chronic obstructive pulmonary disease].
BACKGROUND
The study was conducted to investigate the safety of "hospital at home" versus hospital care.


METHODS
It was a prospective randomised controlled trial. Patients with an exacerbation of chronic obstructive pulmonary disease (COPD) were included and randomised to supported discharge (n = 22) or to conventional in-patient care (n = 22). Outcome measures were readmissions, complications, mortality within 60 days of initial admission.


RESULTS
390 patients (COPD) were admitted and 44 patients (12%) were included in the study. In the home treatment period 2 patients (9%) were readmitted. One patient (4.5%) died 2 weeks after discharge from the home treatment. In the follow-up period 3 patients in the home treated group were readmitted 7 times (31.8%), and 7 patients in the conventional in-patient group were readmitted 9 times (40.9%). There were 14 complications (63.6%) in the home treated group and 15 complications (68.3%) in the conventional in-patient group. The length of hospital stays in the supported discharged group were shorter (1.3 (std = 0.5) versus 3.7 (std = 2.8) days, p = 0.002). After discharge a respiratory nurse visited supported discharged patients at home during 5.1 days (min. 2 days, max. 13 days) with 2.6 visits per patient (min. 1, max 6 visits).


CONCLUSIONS
This study shows that home supported discharge is a well tolerated, safe and economic alternative to hospital admission for a proportion of patients referred to hospital for admission for COPD.
Nissen
Ingolf
I
Sygehus Nord, Thisted, Medicinsk Afdeling. nissen@post.tdcadsl.dk
Jensen
Michael Skov
MS
D005260:Female; D005500:Follow-Up Studies; D006699:Home Care Services / Q000191:economics / Q000592:standards; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D010359:Patient Readmission; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000401:mortality / Q000451:nursing* / Q000628:therapy; D012449:Safety; D000078329:Workforce