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

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Abstract

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.

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Authors and Affiliations

  1. Division of Pulmonary, Critical Care, & Sleep Medicine, Icahn School of Medicine at Mount Sinai, 1468 Madison Avenue, Annenberg Building 5th Floor, Room 5-20, New York, NY, 10029, USA

    Julia Budde & Sidney S. Braman

  2. Institute for Health Care Delivery Science at Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, 1425 Madison Avenue, Icahn Building, Floor L2, New York, NY, 10029, USA

    Parul Agarwal

  3. Institute for Health Care Delivery Science at Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, 1425 Madison Avenue, Second Floor, Room, New York, NY, 10029, USA

    Madhu Mazumdar

  4. Division of Hospital Medicine, Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Jonathan Yeo

  5. Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1149, New York, NY, 10029, USA

    Jonathan Yeo

Authors
  1. Julia Budde
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  2. Parul Agarwal
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  3. Madhu Mazumdar
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  4. Jonathan Yeo
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  5. Sidney S. Braman
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Corresponding author

Correspondence to Sidney S. Braman.

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Budde, J., Agarwal, P., Mazumdar, M. et al. Can an Emergency Department Observation Unit Reduce Hospital Admissions for COPD Exacerbation?. Lung 196, 267–270 (2018). https://doi.org/10.1007/s00408-018-0102-1

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  • DOI: https://doi.org/10.1007/s00408-018-0102-1

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