Estimating the frequency and cost of emergency department presentations and hospitalisation of chronic obstructive pulmonary disease patients: A retrospective analysis from regional Queensland
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Gow, Jeff
Moloney, Clint
King, Alex
Keijzers, Gerben
Beccaria, Gavin
Mullens, Amy
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Abstract
Objective: Chronic obstructive pulmonary disease (COPD) patients commonly have frequent visits to the ED. Consequently, COPD has a significant effect on total healthcare expenditure. The objective was to measure the frequency of ED presentation and hospitalisation among COPD patients and to estimate the costs resulting from such care utilisation. Methods: This was a causal-comparative non-experimental research design conducted in three regional hospitals between 2016 and 2018. Two different original data sets were used: an automated hospital data set and an audit of patient charts. Secondary cost data were also used. Data were analysed using Pearson's χ2 test to estimate the relationship between several patient and treatment-related characteristics. Results: There were 5253 patient presentations at ED and hospital length of stay data were available for 5079 COPD patients. The total cost of hospital stays was $42.14 million for the time period and the mean average cost was $8297 for ED patients who were admitted to hospital. Factors significantly associated with hospital length of stay were age and time spent in the ED. Noticeably, one (51.7%) in two COPD patients were discharged from ED (all destinations) within 4 h irrespective of their triage category. Conclusions: COPD patient presentation to ED and admission to hospital is an expensive method of providing healthcare to manage this chronic condition. Clinical practitioners and policy makers need to develop and implement optimal integrated care management systems to reduce this hospitalisation rate and reduce the societal costs associated with COPD patient management.
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Emergency Medicine Australasia
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© 2020 ACEM and ASEM. This is the peer reviewed version of the following article: Estimating the frequency and cost of emergency department presentations and hospitalisation of chronic obstructive pulmonary disease patients: A retrospective analysis from regional Queensland, Emergency Medicine Australasia, Early View, 2020, which has been published in final form at 10.1111/1742-6723.13665. 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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Clinical sciences
Health services and systems
Public health
Science & Technology
Life Sciences & Biomedicine
Emergency Medicine
chronic obstructive pulmonary disease
cost
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Rana, R; Gow, J; Moloney, C; King, A; Keijzers, G; Beccaria, G; Mullens, A, Estimating the frequency and cost of emergency department presentations and hospitalisation of chronic obstructive pulmonary disease patients: A retrospective analysis from regional Queensland, Emergency Medicine Australasia, 2020