title: Risk factors of hospitalization and readmission of patients with COPD in Hong Kong population: analysis of hospital admission records.
abstract: BACKGROUND
  Chronic Obstructive Pulmonary Disease (COPD) accounts for around 4% of all public hospital annual admissions in Hong Kong. By year 2020, COPD will be ranked fifth among the conditions with the highest burden to the society. This study identifies admission and unplanned readmission of COPD patients, factors affecting unplanned readmission, and estimates its cost burden on the public healthcare system in Hong Kong.
  
  
  METHODS
  This is a retrospective study analyzing COPD admissions to all public hospitals in Hong Kong. All admission episodes to acute medical wards with the principal diagnosis of COPD (ICD-9:490-492, 494-496) from January 2006 to December 2007 were captured. Unplanned readmission was defined as an admission which followed a previous admission within 30 days.
  
  
  RESULTS
  In 2006 and 2007, 65497 (8.0%) of episodes from medical wards were identified as COPD admissions, and among these, 15882 (24.2%) were unplanned readmissions. The mean age of COPD patients was 76.81 ± 9.59 years and 77% were male. Unplanned readmission was significantly associated with male gender, receiving public assistance and living in nursing homes while no association was found with the Charlson comorbidity index. Patients who were readmitted unplanned had a significant longer acute length of stay (β = 0.3894, P < 0.001) after adjustment for other covariates.
  
  
  CONCLUSIONS
  Unplanned readmission of COPD patients has a huge impact on the public healthcare system. A systematic approach in programme provision and a good discharge planning process targeting on COPD patients who are at high risk of unplanned readmission are essential.
authors.affiliation: School of Public Health and Primary Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, N.T., Hong Kong. cwkfrank@cuhk.edu.hk
authors.forename: Frank W K
authors.initials: FW
authors.lastname: Chan
authors.forename: Fiona Y Y
authors.initials: FY
authors.lastname: Wong
authors.forename: Carrie H K
authors.initials: CH
authors.lastname: Yam
authors.forename: Wai-ling
authors.initials: WL
authors.lastname: Cheung
authors.forename: Eliza L Y
authors.initials: EL
authors.lastname: Wong
authors.forename: Michael C M
authors.initials: MC
authors.lastname: Leung
authors.forename: William B
authors.initials: WB
authors.lastname: Goggins
authors.forename: Eng-kiong
authors.initials: EK
authors.lastname: Yeoh
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006723:Hong Kong; D006801:Humans; D008297:Male; D008485:Medical Audit; D010359:Patient Readmission / Q000639:trends*; D029424:Pulmonary Disease, Chronic Obstructive; D012189:Retrospective Studies; D012307:Risk Factors