UCL Discovery
UCL home » Library Services » Electronic resources » UCL Discovery

Understanding variation in length of hospital stay for COPD exacerbation: European COPD audit

Ruparel, M; Lopez-Campos, JL; Castro-Acosta, A; Hartl, S; Pozo-Rodriguez, F; Roberts, CM; (2016) Understanding variation in length of hospital stay for COPD exacerbation: European COPD audit. ERJ Open Research , 2 (1) , Article 00034-2015. 10.1183/23120541.00034-2015. Green open access

[thumbnail of COPD LOS.pdf]
Preview
Text
COPD LOS.pdf - Published Version

Download (419kB) | Preview

Abstract

Chronic obstructive pulmonary disease (COPD) care across Europe has high heterogeneity with respect to cost and the services available. Variations in length of stay (LOS) may be attributed to patient characteristics, resource and organisational characteristics, and/or the so-called hospital cluster effect. The European COPD Audit in 13 countries included data from 16 018 hospitalised patients. The recorded variables included information on patient and disease characteristics, and resources available. Variables associated with LOS were evaluated by a multivariate, multilevel analysis. Mean±SD LOS was 8.7±8.3 days (median 7 days, interquartile range 4–11 days). Crude variability between countries was reduced after accounting for clinical factors and the clustering effect. The main factors associated with LOS being longer than the median were related to disease or exacerbation severity, including GOLD class IV (OR 1.77) and use of mechanical ventilation (OR 2.15). Few individual resource variables were associated with LOS after accounting for the hospital cluster effect. This study emphasises the importance of the patients’ clinical severity at presentation in predicting LOS. Identifying patients at risk of a long hospital stay at admission and providing targeted interventions offers the potential to reduce LOS for these individuals. The complex interactions between factors and systems were more important that any single resource or organisational factor in determining differences in LOS between hospitals or countries.

Type: Article
Title: Understanding variation in length of hospital stay for COPD exacerbation: European COPD audit
Open access status: An open access version is available from UCL Discovery
DOI: 10.1183/23120541.00034-2015
Publisher version: http://dx.doi.org/10.1183/23120541.00034-2015
Language: English
Additional information: Distributed under the Creative Commons Attribution-Non-Commercial 4.0 International License (CC-BY-NC), as described at http://creativecommons.org/licenses/by-nc/4.0/. This license permits non-commercial use, including reproduction, adaptation, and distribution of the article provided the original author and source are credited.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
URI: https://discovery.ucl.ac.uk/id/eprint/1477351
Downloads since deposit
132Downloads
Download activity - last month
Download activity - last 12 months
Downloads by country - last 12 months

Archive Staff Only

View Item View Item