Can an Emergency Department Observation Unit Reduce Hospital Admissions for COPD Exacerbation?

• Published in: Lung Vol. 196; no. 3; pp. 267 - 270
• Main Authors: Budde, Julia, Agarwal, Parul, Mazumdar, Madhu, Yeo, Jonathan, Braman, Sidney S.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.06.2018; Springer; Springer Nature B.V
• Subjects: Availability; Care and treatment; Chronic obstructive lung disease; Chronic obstructive pulmonary disease; COPD; Development and progression; Diagnosis; Emergency medical services; Health care; Health care facilities; Hospital admission and discharge; Hospital emergency services; Lung diseases; Management; Medicine; Medicine & Public Health; Patient admissions; Pneumology/Respiratory System; Regression analysis; Resource utilization; Emergency department; Acute exacerbation of chronic obstructive pulmonary disease; Hospital admission; Clinical decision unit; Observation unit
• ISSN: 0341-2040; 1432-1750
• DOI: 10.1007/s00408-018-0102-1

Studies on observation unit (OU) use to avoid a hospital admission from the emergency department (ED) have found variable effects on health care resource utilization, and these effects have not been studied in acute exacerbation of chronic obstruction pulmonary disease (AECOPD). We retrospectively collected data for all AECOPD-related ED visits (age > 40) to an urban, academic medical center between February 2013 and April 2017. We examined the total proportion of visits admitted to the hospital before and after availability of an OU and the proportion of visits discharged directly from the ED using segmented regression analysis. There was a 12.8% reduction in hospital admissions after OU availability (79.6 vs. 66.8%, p  = 0.0049) without a change in the proportion discharged directly from the ED ( p  = 0.65). The availability of an OU can decrease hospital AECOPD admissions without affecting the number of patients discharged directly from the ED.