Differences in COPD-related readmissions to primary and secondary care hospitals

Objective. To study differences in readmissions to primary and secondary care hospitals for exacerbations of chronic obstructive pulmonary disease (COPD). Design. A register-based study. Subjects. The data were gathered from the hospital admissions register of the Finnish National Research and Devel...

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Bibliographic Details
Published in:Scandinavian journal of primary health care 2009-01, Vol.27 (2), p.80-84
Main Authors: Lampela, Pekka, Säynäjäkangas, Olli, Jokelainen, Jari, Keistinen, Timo
Format: Article
Language:English
Subjects:
Acute Disease
Acute exacerbation
Adult
Aged
Aged, 80 and over
Chronic Disease
Chronic obstructive pulmonary disease
Discharged
Emergencies
Family Practice
Female
Finland
general practice
hospitalization
Hospitals
Humans
Length of Stay
Male
Middle Aged
Original
Outcome Assessment, Health Care
Patient Readmission
Primary Health Care
Pulmonary Disease, Chronic Obstructive - therapy
Quality Assurance, Health Care
Readmission
Registries
Respiratory diseases
Risk Factors
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Summary:Objective. To study differences in readmissions to primary and secondary care hospitals for exacerbations of chronic obstructive pulmonary disease (COPD). Design. A register-based study. Subjects. The data were gathered from the hospital admissions register of the Finnish National Research and Development Centre for Welfare and Health. The data included all acute periods of treatment received by COPD patients aged over 44 years in 1996-2004 who had a principal or subsidiary diagnosis of COPD (ICD 10: J41-J44), respiratory infection (ICD 10: J00-J39, J85-J86) or cardiac insufficiency (ICD 10: I50), followed by an emergency readmission. Treatment had to have taken place in either a primary care hospital or a specialized ward for respiratory diseases or internal medicine in a secondary care hospital. Main outcome measures. The risk of readmission within a week of discharge, analysed by site of care. Results. The risk of readmission within seven days of discharge is 1.74-fold for a patient treated in primary care compared with a patient treated in secondary care. Conclusions. COPD patients discharged from primary care hospitals have a greater risk of readmission, particularly within a week, than those discharged from secondary care. This risk may be attributed to differences in treatment procedures and arrangement of subsequent care. Thus, in the future, more attention should be paid to primary healthcare resources and staff training.
ISSN:0281-3432
1502-7724
DOI:10.1080/02813430802673501