[Early supported discharge for patients with exacerbations of chronic obstructive pulmonary disease].
BACKGROUND
Hospital admissions due to exacerbations of COPD are frequent. UK studies have shown that early supported discharge (ESD) for patients with exacerbations of COPD can reduce the length of stay without adversely affecting mortality or readmission rates. However, experience of ESD in Denmark has not been reported.


METHODS
Hospital admissions due to exacerbations of COPD at Hvidovre Hospital in a 1-year period were reviewed.


RESULTS
In the study period, the number of admissions due to exacerbations was 875 and the mean length of stay was 6.3 days in contrast to 5.8 days the previous year; 159 (18.2%) admissions in 108 patients were suitable for ESD. Prior to ESD, the mean duration of in-hospital stay was 4.0 days. Patients selected for ESD had severe COPD with FEV1 31.8% (7-89%) of predicted value. They had on average 3.8 (1-11) home visits in a mean period of 10.5 (1-29) days. While being cared for at home, one patient died and readmission was necessary in 19 (17.6%) cases. Within three months 51.4% of the patients were readmitted and 14.8% died. The income and costs related to ESD were approximately 120,000 EUR and 75,000 EUR, respectively.


CONCLUSIONS
Almost 20% of all admissions were eligible for ESD. Compared to British studies on ESD, our patients had more severe COPD. We cannot determine whether this model of care has reduced days in hospital, but costs and income seem to balance.
Ringbaek
Thomas J
TJ
Hvidovre Hospital, Hjerte-lungemedicinsk Afdeling. ringbaek@dadlnet.dk
Nielsen
Lise-Lotte
LL
Admasu
Hanna
H
Lange
Peter
P
D000368:Aged; D003718:Denmark; D005260:Female; D018575:Home Care Services, Hospital-Based / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D010359:Patient Readmission / Q000191:economics / Q000706:statistics & numerical data; D017060:Patient Satisfaction; D029424:Pulmonary Disease, Chronic Obstructive / Q000401:mortality / Q000451:nursing / Q000628:therapy*; D011795:Surveys and Questionnaires