Risk factors of hospitalization and readmission of patients with COPD in Hong Kong population: analysis of hospital admission records.

Frank W K Chan,Wai-ling Cheung,Eng-kiong Yeoh,Carrie H K Yam,William B Goggins,Michael C M Leung,Fiona Y Y Wong,Eliza L Y Wong

doi:10.1186/1472-6963-11-186

Frank W K Chan, Wai-ling Cheung + Show 6 more

Open Access

https://doi.org/10.1186/1472-6963-11-186

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Abstract

BackgroundChronic Obstructive Pulmonary Disease (COPD) accounts for around 4% of all public hospital annual admissions in Hong Kong. By year 2020, COPD will be ranked fifth among the conditions with the highest burden to the society. This study identifies admission and unplanned readmission of COPD patients, factors affecting unplanned readmission, and estimates its cost burden on the public healthcare system in Hong Kong.MethodsThis is a retrospective study analyzing COPD admissions to all public hospitals in Hong Kong. All admission episodes to acute medical wards with the principal diagnosis of COPD (ICD-9:490-492, 494-496) from January 2006 to December 2007 were captured. Unplanned readmission was defined as an admission which followed a previous admission within 30 days.ResultsIn 2006 and 2007, 65497 (8.0%) of episodes from medical wards were identified as COPD admissions, and among these, 15882 (24.2%) were unplanned readmissions. The mean age of COPD patients was 76.81 ± 9.59 years and 77% were male. Unplanned readmission was significantly associated with male gender, receiving public assistance and living in nursing homes while no association was found with the Charlson comorbidity index. Patients who were readmitted unplanned had a significant longer acute length of stay (β = 0.3894, P < 0.001) after adjustment for other covariates.ConclusionsUnplanned readmission of COPD patients has a huge impact on the public healthcare system. A systematic approach in programme provision and a good discharge planning process targeting on COPD patients who are at high risk of unplanned readmission are essential.

Highlights

Chronic Obstructive Pulmonary Disease (COPD) accounts for around 4% of all public hospital annual admissions in Hong Kong
Among all the admission episodes retrieved from the Hospital Authority (HA) computer system, 65497 (8.0%) episodes were identified with principal diagnosis of COPD in the year 2006 and 2007
It was found that patients with unplanned readmission episodes were slightly younger (76.74 ± 9.34 vs 76.83 ± 9.67, P = 0.020), more predominantly male (81.2% vs 75.7%, P < 0.001), more likely to be receiving public assistance (51.9% vs 41.2%, P < 0.001), and living in nursing homes (24.1% vs 17.6%, P < 0.001), compared with those who were not readmitted unplanned

Summary

Introduction

Chronic Obstructive Pulmonary Disease (COPD) accounts for around 4% of all public hospital annual admissions in Hong Kong. This study identifies admission and unplanned readmission of COPD patients, factors affecting unplanned readmission, and estimates its cost burden on the public healthcare system in Hong Kong. It has been estimated that by the year 2020, COPD will be ranked third among the most important causes of death and fifth among the conditions with a high burden to society for both sexes worldwide [2]. In the European Union, the total direct costs of respiratory disease are estimated to be about 6% of the total health care budget, with COPD accounting for 56% (USD 53.9 billion) of the cost spent on respiratory disease [1]. In the US, the direct cost of COPD was US$18 billion in 2002 [1]

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