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An association between length of stay and co-morbidity in chronic airflow limitation
A J Crockett1, J M Cranston, J R Moss
1Respiratory Unit, Flinders Medical Centre and Flinders University, Bedford Park, South Australia. alan.crockett@flinders.edu.au
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 > or = 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:female, 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.
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