title: All Danish first-time COPD hospitalisations 2002-2008: incidence, outcome, patients, and care.
abstract: OBJECTIVE
  This study aimed to investigate trends in first-time hospitalisations with chronic obstructive pulmonary disease (COPD) in a publicly financed healthcare system during the period from 2002 to 2008 with respect to incidence, outcome and characteristics of hospitalisations, departments, and patients.
  
  
  METHODS
  Using health administrative data from national registers, all first-time hospitalisations with COPD in Denmark (population 5.4 million) were identified. Data based on the individual hospitalisations and patients were retrieved and analysed.
  
  
  RESULTS
  During the period 2002 to 2008 the total rate of COPD hospitalisations decreased from 460 to 410 per 100,000 person years. Among persons above 45 years of age, the age- and sex-adjusted incidence rate of first-time COPD hospitalisations decreased by 8.2% (95% CI 5.0-11.2%). The inpatient mortality increased OR 1.16 (95% CI 1.01-1.34) and the one-year mortality increased OR 1.12 (95% CI 1.03-1.21). Concurrently, significant age- and sex-adjusted increases were found in use of intensive care, comorbidity, patient travel distance, bed occupancy rate of the receiving department, prior use of oral and inhaled corticosteroids, use of outpatient clinics and encounters in general practice, while length of stay and number of receiving hospitals decreased.
  
  
  CONCLUSIONS
  Decreasing rate of first-time COPD hospitalisations combined with shorter lengths of stay and increasing severity of cases indicates that the use of hospital beds for COPD exacerbations has been gradually restricted. This may be causally related to both the centralisation into overcrowded departments and the improved outside hospital treatment of COPD, also demonstrated in this study.
authors: Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, J. B. Winsløws Vej 9A, 1, DK-5000 Odense C, Denmark. jlykkegaard@health.sdu.dk
authors: Jesper
authors: J
authors: Lykkegaard
authors: Jens
authors: J
authors: Søndergaard
authors: Jakob
authors: J
authors: Kragstrup
authors: Jesper
authors: J
authors: Rømhild Davidsen
authors: Thomas
authors: T
authors: Knudsen
authors: Morten
authors: M
authors: Andersen
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001509:Bed Occupancy / Q000706:statistics & numerical data / Q000639:trends; D003718:Denmark / Q000453:epidemiology; D005260:Female; D017052:Hospital Mortality / Q000639:trends; D006760:Hospitalization / Q000706:statistics & numerical data / Q000639:trends*; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units / Q000706:statistics & numerical data / Q000639:trends; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology*; D017678:Sex Distribution; D016896:Treatment Outcome