Does distance to hospital affect emergency department presentations and hospital length of stay among COPD patients?

Rana, Rezwanul and Gow, Jeff and Moloney, Clint ORCID: https://orcid.org/0000-0003-2520-1506 and King, Alex and Keijzers, Gerben and Beccaria, Gavin ORCID: https://orcid.org/0000-0002-4341-804X and Mullens, Amy (2020) Does distance to hospital affect emergency department presentations and hospital length of stay among COPD patients? Internal Medicine Journal. pp. 1-20. ISSN 1444-0903


Abstract

Background
The primary goal of COPD management is to optimize a patient's functional status and quality of life. By encouraging effective patient self‐management within primary health care, unplanned and potentially avoidable COPD admissions to the emergency department can be avoided.

Aim
The aim of this study is to examine whether distance to hospital influences the rate of ED presentation, hospital admission and hospital length of stay for COPD patients.

Methods
The 2016 to 2018 resulted in a total of 5253 patient presentations with a primary medical diagnosis code of J44 (COPD). These were at the main hospitals of three Queensland Hospital and Health Services: Toowoomba, Ipswich and Gold Coast. To examine the variations in patient characteristics based on distance a one‐way ANOVA (Analysis of Variance) test was conducted. The Kruskal‐Wallis (KW) test indicated that there were group differences.

Results
This study identified significant variation in COPD‐related hospital length of stay and distance to hospital among COPD patients within three hospitals in South East Queensland, Australia. These results confirm that distance plays an important role in determining duration of hospital stay (in number of days) among COPD patients, with clear evidence of the distance ‘decay phenomenon'. It appears from the findings of the current study that distance to the hospital is not associated with the greater likelihood of ED presentation but may influence length of stay.

Conclusions
Several distance‐specific studies have concluded that lower utilisation of hospital care is associated with distance to hospital.


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Item Type: Article (Commonwealth Reporting Category C)
Refereed: Yes
Item Status: Live Archive
Faculty/School / Institute/Centre: Current - Institute for Resilient Regions - Centre for Health Research (1 Apr 2020 -)
Faculty/School / Institute/Centre: Historic - Faculty of Business, Education, Law and Arts - School of Commerce (1 Jul 2013 - 17 Jan 2021)
Date Deposited: 03 Dec 2020 05:28
Last Modified: 03 Jan 2021 23:28
Uncontrolled Keywords: distance, COPD, regional hospital, emergency department, length of stay, Australia
Fields of Research (2008): 11 Medical and Health Sciences > 1117 Public Health and Health Services > 111712 Health Promotion
Fields of Research (2020): 42 HEALTH SCIENCES > 4206 Public health > 420603 Health promotion
42 HEALTH SCIENCES > 4206 Public health > 420605 Preventative health care
Identification Number or DOI: https://doi.org/10.1111/imj.15014
URI: http://eprints.usq.edu.au/id/eprint/40202

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