Impact of a COPD discharge care bundle on readmissions following admission with acute exacerbation: interrupted time series analysis.

North West London
Published Date: 13 Feb 2015

OBJECTIVES:

We evaluated the impact of a COPD discharge care bundle on readmission rates following hospitalisation with an acute exacerbation.

PARTICIPANTS:

Patients aged 45 years and older admitted to an NHS acute hospital in England for acute exacerbation of COPD. Data come from Hospital Episode Statistics, April 2002 to March 2012.

MAIN OUTCOME MEASURES:

Annual trend readmission rates (and in total bed days) within 7, 28 and 90 days, before and after implementation.

RESULTS:

In hospitals introducing the bundle readmission rates were rising before implementation and falling afterwards (e.g. readmissions within 28 days +2.13% per annum (pa) pre and -5.32% pa post (p for difference in trends = 0.012)). Following implementation, readmission rates within 7 and 28 day were falling faster than among other trusts in London, although this was not statistically significant (e.g. readmissions within 28 days -4.6% pa vs. -3.2% pa, p = 0.44). Comparisons with a national control group were similar.

Contact 
Anthony Laverty
a.laverty@imperial.ac.uk