TY - JOUR T1 - Early discharge COPD experience: Reduction of severe exacerbations requiring hospitalisation JF - European Respiratory Journal JO - Eur Respir J VL - 40 IS - Suppl 56 SP - P604 AU - Joanne King AU - Rachel Arnold AU - Richard Russell AU - Mona Bafadhel Y1 - 2012/09/01 UR - http://erj.ersjournals.com/content/40/Suppl_56/P604.abstract N2 - Introduction Hospital at home schemes for COPD exacerbations are used but evidence to support them with reductions in exacerbations or mortality has not been wholley conclusiveMethod Data 12 months pre & post instigation of an early discharge with admission avoidance service (EDS-AA) was available to COPD exacerbation patients hospitalised at our hospital, providing care to a population of 450000, covering the Bucks (B) & East Berks (EB) area. Currently only patients from EB qualify for care with the EDS-AA team. The EDS-AA team takes patients home within 5 days of admission & offer support for 10 days after. Subsequent to this, patients are offered direct EDS-AA team access, including home visits,telephone advice & self-management strategiesResult Data was available in 95 COPD patients hospitalised with a severe COPD exacerbation. The mean (range) age was 75 (48-99) years & severity of COPD was classified as GOLD I, II, III & IV in 5%, 33%, 31% & 31% of patients. The mean (range) exacerbation frequency prior to the EDS-AA service was 1 (0-4) in all patients. 64% of exacerbations occurred in patients from the EB group & were discharged with the EDS-AA service. There was a significant reduction in the 12 month exacerbation rate requiring hospitalisation in the EB group (mean difference -0.5, 95% CI -0.8 to -0.2, p=0.003) but not the B group (mean difference 0.0, 95%CI -0.4 to 0.3, p=0.865). Mortality was not different in patients on the EDS-AA service compared to those that were not (13% vs. 9%, p=0.43)Conclusion The institution of a specialised EDS-AA service at our hospital was associated with reductions in COPD exacerbations requiring hospitalisation & has significant cost implications. ER -