Pushparajah S, McClellan R, Henry A, Kuitert L
Chronic obstructive pulmonary disease (COPD) accounts for a large number of hospital admissions and numerous interventions have attempted to reduce exacerbations requiring hospitalization. This paper describes the implementation of a community based programme to improve home management of COPD.
125 patients referred with COPD exacerbations met the criteria for the service; 95 received the intervention and data were available for 80. Median FEV1 was 0.86 L. Admission data, length of stay and total hospitalization days with COPD were compared for one year before and after the intervention.
Overall there was no reduction in length of stay, admission frequency, or adjusted total hospitalization days with COPD, but median time interval to next exacerbation increased by 29%. In those who had had previous admissions (mean FEV1 0.58 L) total hospitalization days fell by 27% and length of stay fell by 58%.
The implementation of a Chronic Disease Management programme increased the time to next hospitalized exacerbation. Benefit was seen in the more severely affected patients however, with a significant reduction in both length of stay and total hospitalization days.
Chronic Respiratory Disease 2006 3(4):187-193