ED visit volume and quality of care in acute exacerbations of chronic obstructive pulmonary disease

The American Journal of Emergency Medicine
Chu-Lin TsaiCarlos A Camargo

Abstract

The purpose of this study is to determine whether emergency department (ED) visit volume is associated with ED quality of care in patients with acute exacerbations of chronic obstructive pulmonary disease (COPD). We performed a prospective multicenter cohort study involving 29 EDs in the United States and Canada. Using a standard protocol, we interviewed consecutive ED patients with COPD exacerbation, reviewed their charts, and completed a 2-week telephone follow-up. The associations between ED visit volume and quality of care (process and outcome measures) were examined at both the ED and patient levels. After adjustment for patient mix in the multivariable analyses, chest radiography was less frequent among patients with COPD exacerbations in the low-volume (odds ratio [OR], 0.2; 95% confidence interval [CI], 0.1-0.4) and high-volume EDs (OR, 0.1; 95% CI, 0.05-0.5), with medium-volume EDs as the reference. Arterial blood gas testing was less frequent in the low-volume EDs (OR, 0.1; 95% CI, 0.02-0.8). Medication use was similar across volume tertiles. With respect to outcome measures, patients in high-volume EDs were more likely to be discharged (OR, 4.2; 95% CI, 2.2-7.7) and to report ongoing exacerbation at a 2-week follow-u...Continue Reading

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Citations

Mar 24, 2011·Respiratory Research·Sigrid N W VorrinkJan-Willem J Lammers
Nov 26, 2011·BMC Health Services Research·José M QuintanaUNKNOWN IRYSS-COPD Group
Jun 13, 2012·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Chu-Lin TsaiCarlos A Camargo
Jun 16, 2010·Health Services Research·Ying P TabakRichard S Johannes
May 30, 2020·JAMA Network Open·Julie KanterMarsha Treadwell

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