Abstract
Rationale Admissions for chronic obstructive pulmonary disease (COPD) are frequent and associated with high costs. In recent years initiatives in our Healthcare System have advanced the quality of care. We hypothesized that there would be improvement in care provided during admission for COPD in 2010 compared to 2005-06.
Methods We performed a chart review of hospitalizations for exacerbation of COPD in 2005-06 and 2010 at five hospitals. Admissions were identified by ICD9 diagnosis code (COPD, emphysema, chronic bronchitis and chronic obstructive asthma). Demographics, medications, vaccinations and smoking cessation were recorded. Chi-squared tests compared rates among the groups.
Results There were 989 unique patients admitted in 2005-06 and 1,261 in 2010. Patients were 73±12 years old, 42% male, 60% Caucasian, 17% African American and 18% Hispanic. In 2010, hospitalized patients were more likely to be treated with steroids (89.7% vs. 81.5% in 2005-06, P<0.001), bronchodilators (95.9% vs. 90.7% in 2005-06, P<0.001) and antibiotics (82.9% vs. 79.0% in 2005-06, P=0.02), and more likely to be discharged on a bronchodilator (88.3% vs. 74.2% in 2005-06, P<0.001). Active smokers were more likely to be counseled on smoking cessation in 2010 (93.9% vs. 61.5% in 2005-06, P<0.001). Vaccination status was assessed more often in 2010 (78.8% vs. 55.0% in 2005-06 for influenza, P<0.001, and 78.1% vs. 59.3% in 2005-06 for pneumococcal vaccine, P<0.001).
Conclusions During admissions for exacerbation of COPD at 5 hospitals in our Healthcare System, there were significant improvements from 2005-06 to 2010 in quality of care; however, there continues to be room for improvement.
- © 2014 ERS
