Summary
Differences in Emergency Department care for patients with exacerbated acute chronic obstructive pulmonary disease according to level of care: Phase 1 in a study of COPD care in the Emergency Departments of Castilla-León, Spain
Affiliation of the authors
DOI
Quote
Alonso Avilés R, Macías García S, Elescano Barrientos KP, Heredia Moldes S, De Diego Arnaiz M, Vicario Jiménez N, Santos Orus ML, Zalama Sánchez D. Differences in Emergency Department care for patients with exacerbated acute chronic obstructive pulmonary disease according to level of care: Phase 1 in a study of COPD care in the Emergency Departments of Castilla-León, Spain. Rev Esp Urg Emerg. 2023;2:220–3
Summary
BACKGROUND AND OBJECTIVE. After previously demonstrating variability in care for patients with exacerbated chronic obstructive pulmonary disease (COPD) in hospital emergency departments (EDs) in Castile-León, we aimed to assess whether care varies according to the hospitals’ care level.
MATERIAL AND METHODS. We stratified the database from Phase 1 of the cross-sectional descriptive study of care in 14 EDs in our Spanish autonomous community, according to university affiliation (yes/no) and level of care available at each hospital in 2021. Univariate and bivariate analyses were performed on all continuous variables, and Fisher or Kruskal-Wallis tests were used to assess associations between continuous variables and ED classification. The level of significance was set at P < .05.
RESULTS. We detected significant differences in care according to hospital classification in 2 variables: the number of patients with exacerbated COPD attended in the ED (P = .01) and the number of hospitalizations (P = .03). However, we found no differences in the number of patients with re-exacerbations (P = .43), the mean duration of hospital stay in days (P = .80), or the number of patients kept under observation (P = .13).
CONCLUSIONS. Care for patients with exacerbated COPD does not differ significantly according to the hospitals’ care-level classification, in spite of the various differences between the hospitals. Better internal and external organization of hospital resources in Castile-León is required in the interest of providing better ED management of COPD in this Spanish autonomous community.