Abstract
Purpose
The aim of this study was to describe population-based patterns of chronic obstructive
pulmonary disease (COPD)–related emergency department (ED) visits.
Methods
We analyzed all COPD-related ED visits made by North Carolina residents 45 years or
older in 2008 to 2009 using statewide surveillance system data. Return visits were
identified when patients returned to the same ED within 3 or 14 days of a prior COPD-related
visit. We quantify the prevalence of hospitalization and return visits by age, sex,
and payment method and describe ED disposition patterns.
Results
Nearly half (46.3%) of the 97 511 COPD-related ED visits resulted in hospital admission.
The percent of visits preceded by another COPD-related visit within 3 and 14 days
was 1.6% and 6.2%, respectively. Emergency department–related hospitalizations increased
with age; there were no differences by sex. Hospitalizations were less likely for
uninsured, Medicare, and Medicaid visits than for privately insured visits. In contrast,
3- and 14-day return visits were more likely to be uninsured, Medicare, and Medicaid
visits than privately insured visits. Fourteen-day returns were more likely to be
made by men. Return visits initially increased with age compared with the 45- to 49-year
age group, then decreased steadily after age 65 years. When return visits were made,
discharge at both visits was the most common disposition pattern. However, 33.7% of
3-day returns and 22.7% of 14-day returns were discharged at the first visit and hospitalized
upon returning to the ED.
Conclusions
Chronic obstructive pulmonary disease–related hospital admissions and short-term return
ED visits were common and varied by age and insurance status. Chronic obstructive
pulmonary disease management remains a critical area for intervention and quality
improvement.
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Article Info
Publication History
Published online: August 05, 2013
Accepted:
June 18,
2013
Received in revised form:
June 17,
2013
Received:
April 27,
2013
Footnotes
☆Presentation at a scientific meeting: This study was presented in an oral presentation at the International Society for Disease Surveillance, December 2012, San Diego, CA. The conference abstract was published in a special supplement in the Online Journal of Public Health Informatics (available at: http://pear.accc.uic.edu/htbin/cgiwrap/bin/ojs/index.php/ojphi/article/view/4408/3457).
Identification
Copyright
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
