Does distance to hospital affect emergency department presentations and hospital length of stay among COPD patients?
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Gow, Jeff
Moloney, Clint
King, Alex
Keijzers, Gerben
Beccaria, Gavin
Mullens, Amy
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Abstract
Background: The primary goal of COPD management is to optimize a patient's functional status and quality of life. By encouraging effective patient self-management within primary health care, unplanned and potentially avoidable COPD admissions to the emergency department can be avoided. Aim: The aim of this study is to examine whether distance to hospital influences the rate of ED presentation, hospital admission and hospital length of stay for COPD patients. Methods: The 2016 to 2018 resulted in a total of 5253 patient presentations with a primary medical diagnosis code of J44 (COPD). These were at the main hospitals of three Queensland Hospital and Health Services: Toowoomba, Ipswich and Gold Coast. To examine the variations in patient characteristics based on distance a one-way ANOVA (Analysis of Variance) test was conducted. The Kruskal-Wallis (KW) test indicated that there were group differences. Results: This study identified significant variation in COPD-related hospital length of stay and distance to hospital among COPD patients within three hospitals in South East Queensland, Australia. These results confirm that distance plays an important role in determining duration of hospital stay (in number of days) among COPD patients, with clear evidence of the distance 'decay phenomenon'. It appears from the findings of the current study that distance to the hospital is not associated with the greater likelihood of ED presentation but may influence length of stay. Conclusions: Several distance-specific studies have concluded that lower utilisation of hospital care is associated with distance to hospital. This article is protected by copyright. All rights reserved.
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Internal Medicine Journal
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© 2020 Royal Australasian College of Physicians. This is the peer reviewed version of the following article: Does distance to hospital affect emergency department presentations and hospital length of stay among COPD patients?, Internal Medicine Journal, Accepted Articles, which has been published in final form at 10.1111/imj.15014. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving (http://olabout.wiley.com/WileyCDA/Section/id-828039.html)
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Cardiovascular medicine and haematology
Clinical sciences
Health services and systems
Public health
Australia
COPD
distance
emergency department
length of stay
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Rana, R; Gow, J; Moloney, C; King, A; Keijzers, G; Beccaria, G; Mullens, A, Does distance to hospital affect emergency department presentations and hospital length of stay among COPD patients?, Internal Medicine Journal, 2020