Effectiveness of a Respiratory Day Hospital Program to Reduce Admissions for Exacerbation in Patients with Severe COPD: A Prospective, Multicenter Study.

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  • Additional Information
    • Author-Supplied Keywords:
      Health resources
      hospitalizations
      integrated care
      readmissions
    • NAICS/Industry Codes:
      621498 All Other Outpatient Care Centers
      622110 General Medical and Surgical Hospitals
    • Abstract:
      The respiratory Day Hospital (DH) is a care facility currently operating at various healthcare institutions. It monitors patients with severe chronic obstructive pulmonary disease (COPD) presenting repeated exacerbations with at least two hospital admissions per year. The main aim of the study was to evaluate the effectiveness of the DH program for controlling admissions for COPD exacerbations in this cohort of patients, and to identify clinical factors associated with hospitalizations and mortality. An observational prospective multicenter study was carried out at three hospitals. The sample comprised 150 consecutive patients (median age 70 [65–76] years, FEV133 [26–43]%, 97% males), included at the DH program. Over a one-year period, variables assessing effectiveness and use of healthcare resources were recorded. Factors associated with hospitalizations and mortality were identified. Patients made a median of 4[2–5] emergency visits due to COPD exacerbations with a median of 1[0–2] hospitalization(s)/year. Most of exacerbations (77%) were evaluated at the DH, but there were fewer hospitalizations from the DH than from the emergency department (21% vs. 81%,p< 0.001). In all, 29% of the patients had at least two admissions; these were the patients with the most severe disease. Age, readmission at 30-days and the presence of respiratory failure were the predictors of mortality. In conclusion, the DH program is an effective model for reducing hospitalizations in this cohort of patients. In all, 29% of the patients required two hospital admissions or more; these patients had more advanced disease and poorer prognosis, and would be most likely to benefit from additional care support. [ABSTRACT FROM AUTHOR]
    • Abstract:
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    • Author Affiliations:
      1Respiratory Department, Hospital Universitari de Bellvitge, Institut d'Investigació Biomedica de Bellvitge (IDIBELL), Universitat de Barcelona, Hospitalet de Llobregat, Barcelona, Spain
      2CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
      3Respiratory Department, Hospital de Sabadell, Institut Universitari Parc Taulí-UAB, Sabadell, Barcelona, Spain
      4Universitat Autònoma de Barcelona, Esfera UAB, Barcelona, Spain
      5REDISSEC: Red de Investigación en Servicios de Salud en Enfermedades Crónicas, Madrid, Spain
      6Respiratory Department, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
      7Respiratory Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Biomedical Research Institute Sant Pau, Barcelona, Spain
    • Full Text Word Count:
      5763
    • ISSN:
      1541-2555
    • Accession Number:
      10.1080/15412555.2017.1279598
    • Accession Number:
      123287932
  • Citations
    • ABNT:
      HUERTAS, D. et al. Effectiveness of a Respiratory Day Hospital Program to Reduce Admissions for Exacerbation in Patients with Severe COPD: A Prospective, Multicenter Study. COPD: Journal of Chronic Obstructive Pulmonary Disease, [s. l.], v. 14, n. 3, p. 304–310, 2017. DOI 10.1080/15412555.2017.1279598. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=a9h&AN=123287932&custid=s6224580. Acesso em: 21 jan. 2020.
    • AMA:
      Huertas D, Montón C, Marín A, et al. Effectiveness of a Respiratory Day Hospital Program to Reduce Admissions for Exacerbation in Patients with Severe COPD: A Prospective, Multicenter Study. COPD: Journal of Chronic Obstructive Pulmonary Disease. 2017;14(3):304-310. doi:10.1080/15412555.2017.1279598.
    • APA:
      Huertas, D., Montón, C., Marín, A., Solanes, I., López-Sánchez, M., Pomares, X., … Santos, S. (2017). Effectiveness of a Respiratory Day Hospital Program to Reduce Admissions for Exacerbation in Patients with Severe COPD: A Prospective, Multicenter Study. COPD: Journal of Chronic Obstructive Pulmonary Disease, 14(3), 304–310. https://doi.org/10.1080/15412555.2017.1279598
    • Chicago/Turabian: Author-Date:
      Huertas, Daniel, Concepción Montón, Alicia Marín, Ingrid Solanes, Marta López-Sánchez, Xavier Pomares, Mariana Muñoz-Esquerre, Jordi Dorca, and Salud Santos. 2017. “Effectiveness of a Respiratory Day Hospital Program to Reduce Admissions for Exacerbation in Patients with Severe COPD: A Prospective, Multicenter Study.” COPD: Journal of Chronic Obstructive Pulmonary Disease 14 (3): 304–10. doi:10.1080/15412555.2017.1279598.
    • Harvard:
      Huertas, D. et al. (2017) ‘Effectiveness of a Respiratory Day Hospital Program to Reduce Admissions for Exacerbation in Patients with Severe COPD: A Prospective, Multicenter Study’, COPD: Journal of Chronic Obstructive Pulmonary Disease, 14(3), pp. 304–310. doi: 10.1080/15412555.2017.1279598.
    • Harvard: Australian:
      Huertas, D, Montón, C, Marín, A, Solanes, I, López-Sánchez, M, Pomares, X, Muñoz-Esquerre, M, Dorca, J & Santos, S 2017, ‘Effectiveness of a Respiratory Day Hospital Program to Reduce Admissions for Exacerbation in Patients with Severe COPD: A Prospective, Multicenter Study’, COPD: Journal of Chronic Obstructive Pulmonary Disease, vol. 14, no. 3, pp. 304–310, viewed 21 January 2020, .
    • MLA:
      Huertas, Daniel, et al. “Effectiveness of a Respiratory Day Hospital Program to Reduce Admissions for Exacerbation in Patients with Severe COPD: A Prospective, Multicenter Study.” COPD: Journal of Chronic Obstructive Pulmonary Disease, vol. 14, no. 3, June 2017, pp. 304–310. EBSCOhost, doi:10.1080/15412555.2017.1279598.
    • Chicago/Turabian: Humanities:
      Huertas, Daniel, Concepción Montón, Alicia Marín, Ingrid Solanes, Marta López-Sánchez, Xavier Pomares, Mariana Muñoz-Esquerre, Jordi Dorca, and Salud Santos. “Effectiveness of a Respiratory Day Hospital Program to Reduce Admissions for Exacerbation in Patients with Severe COPD: A Prospective, Multicenter Study.” COPD: Journal of Chronic Obstructive Pulmonary Disease 14, no. 3 (June 2017): 304–10. doi:10.1080/15412555.2017.1279598.
    • Vancouver/ICMJE:
      Huertas D, Montón C, Marín A, Solanes I, López-Sánchez M, Pomares X, et al. Effectiveness of a Respiratory Day Hospital Program to Reduce Admissions for Exacerbation in Patients with Severe COPD: A Prospective, Multicenter Study. COPD: Journal of Chronic Obstructive Pulmonary Disease [Internet]. 2017 Jun [cited 2020 Jan 21];14(3):304–10. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=a9h&AN=123287932&custid=s6224580