title: [Respiratory day hospital: Impact on the rate of hospital admissions due to chronic obstructive pulmonary disease exacerbations].
abstract: OBJECTIVE
  Acute exacerbations of chronic obstructive pulmonary disease (AE-COPD) are considered to be the most important factor in determining the course of the disease, and have great impact on the health care system. We evaluated the effects of a Respiratory Day Hospital (RDH) on the rate of hospital admissions due to AE-COPD.
  
  
  METHODS
  During 14 months, every case of AE-COPD seen at the RDH and emergency services was recruited prospectively. Patients were excluded when another known cause of exacerbation was present and/or when they required invasive mechanical ventilation.
  
  
  RESULTS
  226 episodes (173 patients) were included (72, SD 8 years old). One hundred and twenty one cases received treatment at the RDH (53.5%). Admissions from the RDH group were noticeably lower (32.2 vs. 66.7%, p<0.001), even in patients with more admissions due to AE-COPD the year before the study. There were no differences either in terms of AE-COPD severity or in readmissions and mortality rates during the follow up.
  
  
  CONCLUSIONS
  Management of AE-COPD in a RDH seems to be associated with a lower rate of hospital admissions in comparison with an emergency department.
authors.affiliation: Servicio de Neumología, Hospital de Sabadell, Corporació Sanitària i Universitària Parc Taulí, Universitat Autònoma de Barcelona, Sabadell, España. lcasas@tauli.cat
authors.forename: Luis Fernando
authors.initials: LF
authors.lastname: Casas Méndez
authors.forename: Concepción
authors.initials: C
authors.lastname: Montón Soler
authors.forename: Marisa
authors.initials: M
authors.lastname: Baré Mañas
authors.forename: Jordi
authors.initials: J
authors.lastname: Casabon Salas
authors.forename: Xavier
authors.initials: X
authors.lastname: Pomares Amigó
authors.forename: Urko
authors.initials: U
authors.lastname: Aguirre Larracoechea
mesh_terms: D000208:Acute Disease; D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D017714:Community-Acquired Infections / Q000150:complications / Q000628:therapy; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006785:Hospitals, University / Q000458:organization & administration / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data; D010343:Patient Admission / Q000706:statistics & numerical data; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000453:epidemiology / Q000628:therapy*; D012141:Respiratory Tract Infections / Q000150:complications / Q000628:therapy; D013030:Spain / Q000453:epidemiology