An association between length of stay and co-morbidity in chronic airflow limitation

• Published in: International journal for quality in health care 2000-02, Vol.12 (1), p.41-46
• Main Authors: Crockett, AJ, Cranston, JM, Moss, JR, Alpers, JH
• Format: Article
• Language: English
• Subjects: Adult; chronic airflow limitation; co-morbidity; Comorbidity; Humans; length of stay; Length of Stay - statistics & numerical data; Lung Diseases, Obstructive - complications; Outcome Assessment (Health Care); Patient Discharge - statistics & numerical data; Patient Readmission; readmission; South Australia
• ISSN: 1353-4505; 1464-3677
• DOI: 10.1093/intqhc/12.1.41

Objective.To examine factors which impact on the length of stay and readmission for patients with chronic airflow limitation at a South Australian hospital from December 1996 until March 1998. Design.Discharges from Flinders Medical Centre for patients aged ≥18 years, where chronic airflow limitation was an active problem, and including a subset with a primary diagnosis of chronic airflow limitation, were identified, retrospectively, by the center's Clinical Coding Service from the hospital's in-patient separation database. Setting.Flinders Medical Centre, Adelaide, South Australia. Outcome measures.Length of stay; number of co-morbidities; readmission within 28 days. Results.Five-hundred and twenty discharges (male:femlae, 258:262) with a primary diagnosis of chronic airflow limitation (ANDRG-3 177, chronic obstructive airways disease) were identified. Readmission within 28 days was related to the number of co-morbidities and to age. A relationship between length of stay and the number of co-morbidities was identified. A mean length of stay of 6.39 days was found for patients with less than five co-morbidities, 5.36 at their first admission to Flinders Medical Centre and 3.25 at their first admission to Flinders Medical Centre with no co-morbidities. These mean lengths of stay fall below overseas data previously published and are consistent with Kong's estimate of an ideal mean length of stay of 3.2 days when a clinical management guideline is used in low-risk chronic airflow limitation patients. Conclusions.Length of stay and readmission to hospital within 28 days of patients with a primary diagnosis of chronic airflow limitation is at least partly related to the number of co-morbidities and to age. The study has highlighted the difficulty of relying on changes to aggregate data as outcome measures for these patients.