COPD admissions in an urban environment: Factors influencing length of stay

Background COPD hospitalisations are associated with poor patient prognosis and are the major cost of the condition. Aim The study aimed to describe the distribution of length of stay of repeated admissions among patients hospitalised with COPD exacerbations. It examined variation in length of stay between different hospitals and the secondary care factors which might influence this. Method A retrospective longitudinal study analysed all COPD admissions (2006-2010) to NHS hospitals of patients registered at London practices. Admissions of patients who had not been admitted to hospital with COPD in the previous 15 months were included. Admissions were compared between hospitals and contribution of patient factors, including age, gender and deprivation, to variation in length of stay was calculated. Negative binomial regression used to assess associations between individual hospitals and mean length of stay. Result 38504 admissions from 22462 patients were included. Mean age 72.8 years, 51.7% male. Mean length of stay of first admission 7.6 days. Mean length of stay per admission reduced by 1.0 day (95% CI: 0.7 to 1.4) over four years. Over successive admissions mean length of stay per admission did not increase. Patient age accounted for 2.3% of variance in length of stay and deprivation was not a predictor. Significant variation in length of stay was found between different hospitals. Conclusion Length of stay of admissions for COPD fell from 8.0 to 7.2 days between 2006-2010. Repeated admissions for patients with COPD were not associated with increased length of stay per admission. Length of stay of COPD admissions varied significantly between hospitals and was not influenced by age, gender or deprivation.