1. Effects of an integrated respiratory service on Chronic Obstructive Pulmonary Disease hospital admissions in England: An interrupted time series analysis.
- Author
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Elwenspoek, Martha MC, Jones, Tim, and Dodd, James W
- Subjects
OBSTRUCTIVE lung disease treatment ,LENGTH of stay in hospitals ,CONFIDENCE intervals ,PATIENTS ,PATIENT readmissions ,REGRESSION analysis ,HOSPITAL admission & discharge ,NATIONAL health services ,T-test (Statistics) ,HOSPITAL respiratory therapy services ,TIME series analysis ,DESCRIPTIVE statistics ,CHI-squared test ,RESEARCH funding ,INTEGRATED health care delivery ,STATISTICAL models ,DATA analysis software ,DISEASE exacerbation - Abstract
Objectives: To investigate the effects of an admission avoidance pathway within a new integrated respiratory service on the number of Chronic Obstructive Pulmonary Disease (COPD)-related hospital admissions in England. Methods: We used interrupted time series analysis to estimate the effects of the admission avoidance pathway on COPD hospital admissions, length of stay, and 30-day readmissions. We included all unplanned admissions with COPD as primary diagnosis using Hospital Episode Statistics, comparing the intervention region with a demographically similar control region in the two years before and one year after the implementation of the new service. Results: Unplanned hospital admissions for COPD exacerbations followed a clear seasonal pattern, peaking in early winter. We found no evidence that the admission avoidance pathway influenced the rate of hospital admissions or 30-day readmissions. We found weak evidence of a trend change in length of stay following the launch of the admission avoidance pathway. Conclusions: Our study adds to the growing body of evidence that suggests that additional admission avoidance capacity alone does not lead to a measurable reduction in admissions or length of stay. Further investigation is required to understand the reasons why. A longer follow-up may be required to see some of the potential benefits. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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