Early discharge care with ongoing follow-up support may reduce hospital readmissions in COPD
Maria Lawlor1, Sinead Kealy1, Michelle Agnew1, Bettina Korn1, Jennifer Quinn1, Ciara Cassidy1, Bernard Silke2, Finbarr O’Connell1, Rory O’Donnell1
1Department of Respiratory Medicine, CResT Directorate, St. James’ Hospital, Dublin 8, Ireland; 2Department of General Internal Medicine, Gems Directorate, St. James’ Hospital, Dublin 8, Ireland
Background: Early discharge care and self-management education, although effective in the management of chronic obstructive pulmonary disease (COPD), do not typically reduce hospital re-admission rates for exacerbations of the disease. We hypothesized that a respiratory outreach programme that comprises early discharge care followed by continued rapid-access out-patient support would reduce the need for hospital readmission in these patients.
Methods: Two hundred and forty-six patients, acutely admitted with exacerbations of COPD, were recruited to the respiratory outreach programme that included early discharge care, followup education, telephone support and rapid future access to respiratory out-patient clinics. Sixty of these patients received self-management education also. Emergency department presentations and admission rates were compared at six and 12 months after, compared to prior to, participation in the programme for the same patient cohort.
Results: The frequency of both emergency department presentations and hospital admissions was significantly reduced after participation in the programme.
Conclusions: Provision of a respiratory outreach service that includes early discharge care, followed by education, telephone support and ongoing rapid access to out-patient clinics is associated with reduced readmission rates in COPD patients.
Keywords: COPD management outreach, follow-up, out-patient clinics
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