RT Journal Article
SR Electronic
T1 Home based therapy combined with self management plans reduces re-admission rates for COPD
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 3088
VO 40
IS Suppl 56
A1 Angshu Bhowmik
A1 Matthew Hodson
YR 2012
UL http://erj.ersjournals.com/content/40/Suppl_56/3088.abstract
AB The UK NHS recommends that hospitals take responsibility for patients readmitted within 30 days of discharge. We explored the impact on readmission rates of our “acute COPD early response service” (ACERS), comprising specialist nurses and physiotherapists with medical input from a respiratory physician.The ACERS provided daily hospital-at-home therapy. Domiciliary case-management including self-management plans and rescue packs were provided after the acute therapy period. We measured 30-day and 90-day readmission rates following an admission for exacerbation of COPD over two years starting November 2009, just after the team commenced work, to estimate the impact on readmission rates. The rates between the two years were compared using Fisher's exact test.In the first year, 330 patients were discharged following an exacerbation of COPD. Of these, 58 (17.6%) were readmitted within 30 days and 82 (24.8%) within 90 days. In the second year, there were 271 discharges. The 30 day readmission rate was significantly lower than in the first year at 26 (9.6%) (p=0.006) and the 90 day readmission rate was 45 (16.6%) which was also significantly lower (p=0.016). The month-by-month 30-day readmission rates were generally lower during the second year.ConclusionA dedicated specialist hospital-at-home team for COPD may reduce 30-day and 90-day readmission rates following a hospital admission for COPD exacerbation.