All Danish first-time COPD hospitalisations 2002-2008: Incidence, outcome, patients, and care

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

Objective: This study aimed to investigate trends in first-time hospitalisations with chronic obstructive pulmonary disease (COPD) in a publicly financed healthcare system during the period from 2002 to 2008 with respect to incidence, outcome and characteristics of hospitalisations, departments, and patients. Methods: Using health administrative data from national registers, all first-time hospitalisations with COPD in Denmark (population 5.4 million) were identified. Data based on the individual hospitalisations and patients were retrieved and analysed. Results: During the period 2002 to 2008 the total rate of COPD hospitalisations decreased from 460 to 410 per 100 000 person years. Among persons above 45 years of age, the age- and sex-adjusted incidence rate of first-time COPD hospitalisations decreased by 8.2% (95% CI 5.0-11.2%). The inpatient mortality increased OR 1.16 (95% CI1.01-1.34) and the one-year mortality increased OR 1.12 (95% CI1.03-1.21). Concurrently, significant age- and sex-adjusted increases were found in use of intensive care, comorbidity, patient travel distance, bed occupancy rate of the receiving department, prior use of oral and inhaled corticosteroids, use of outpatient clinics and encounters in general practice, while length of stay and number of receiving hospitals decreased. Conclusion: Decreasing rate of first-time COPD hospitalisations combined with shorter lengths of stay and increasing severity of cases indicates that the use of hospital beds for COPD exacerbations has been gradually restricted. This may be causally related to both the centralisation into overcrowded departments and the improved outside hospital treatment of COPD, also demonstrated in this study.

TidsskriftRespiratory Medicine
Udgave nummer4
Sider (fra-til)549-556
Antal sider8
StatusUdgivet - apr. 2012

Bibliografisk note

Funding Information:
The study was supported by a research fellowship to JL from the University of Southern Denmark , and by a research grant from the Governmental Region of Southern Denmark . None of the funders had a role in the study design, analysis, and interpretation of data, writing of the article, or decision to submit the article for publication. We wish to thank Statistician Pia Veldt Larsen for statistical advice and Secretary Lise Keller Stark for proofreading the manuscript.

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