Early discharge care with ongoing follow-up support may reduce hospital readmissions in COPD.
BACKGROUND
Early discharge care and self-management education, although effective in the management of chronic obstructive pulmonary disease (COPD), do not typically reduce hospital re-admission rates for exacerbations of the disease. We hypothesized that a respiratory outreach programme that comprises early discharge care followed by continued rapid-access out-patient support would reduce the need for hospital readmission in these patients.


METHODS
Two hundred and forty-six patients, acutely admitted with exacerbations of COPD, were recruited to the respiratory outreach programme that included early discharge care, follow-up education, telephone support and rapid future access to respiratory out-patient clinics. Sixty of these patients received self-management education also. Emergency department presentations and admission rates were compared at six and 12 months after, compared to prior to, participation in the programme for the same patient cohort.


RESULTS
The frequency of both emergency department presentations and hospital admissions was significantly reduced after participation in the programme.


CONCLUSIONS
Provision of a respiratory outreach service that includes early discharge care, followed by education, telephone support and ongoing rapid access to out-patient clinics is associated with reduced readmission rates in COPD patients.
Department of Respiratory Medicine, CResT Directorate, St. James' Hospital, Dublin 8, Ireland.
Maria
M
Lawlor
Sinead
S
Kealy
Michelle
M
Agnew
Bettina
B
Korn
Jennifer
J
Quinn
Ciara
C
Cassidy
Bernard
B
Silke
Finbarr
F
O'Connell
Rory
R
O'Donnell
D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data; D003376:Counseling; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data; D010353:Patient Education as Topic; D010359:Patient Readmission / Q000706:statistics & numerical data; D026741:Physical Therapy Modalities; D016730:Program Development; D015397:Program Evaluation; D029424:Pulmonary Disease, Chronic Obstructive / Q000451:nursing / Q000628:therapy*; D012189:Retrospective Studies; D012648:Self Care / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D013689:Telephone; D013997:Time Factors; D016896:Treatment Outcome