The National Asthma and Chronic Obstructive Pulmonary Disease (COPD) Audit Programme (NACAP) provides data on the care received by people with COPD (a group of progressive lung conditions that cause breathing problems) in the United Kingdom (UK). Most COPD patients experience episodes of worsening in respiratory symptoms, termed acute exacerbations of COPD (AECOPD). AECOPD is one of the most common reasons for adult emergency hospital admission in the UK, resulting in significant healthcare usage and cost. The COPD admission hospital data from NACAP (NACAP-SC) contains detailed information on AECOPD hospital admissions. Our study will create a new linkage between primary care data from CPRD and hospital data for AECOPD taken from NACAP-SC. This linked dataset will be used to explore how many admissions for AECOPD are avoidable, and whether receiving specific treatments or being seen within 24 hours of admission by the respiratory team reduce the likelihood of a patient being readmitted or dying.
The National Asthma and Chronic Obstructive Pulmonary Disease (COPD) Audit Programme (NACAP) provides data on the care received by COPD patients in the United Kingdom (UK). Most COPD patients experience episodes of worsening in respiratory symptoms, termed acute exacerbations (AECOPD). AECOPD is one of the most common reasons for adult emergency hospital admission in the UK, resulting in significant healthcare usage and cost. The secondary care clinical arm of NACAP (NACAP-SC) contains detailed information on clinical features of AECOPD hospital admissions. The aim of this study will be to use routinely linked primary care data, Hospital Episode Statistics (HES), and ONS Death registration data from CPRD and bespoke linked secondary care data for AECOPD taken from NACAP-SC. Using logistic regression, this linked dataset will be used to explore the proportion of potentially avoidable admissions: whether contact with primary care in the 2 weeks prior to an AECOPD reduces the risk of an admission being severe; whether different regions of England have different numbers of inappropriate AECOPD admissions; whether receiving a discharge bundle (a completed checklist of best-practice actions to undertake at discharge) increases the odds of receiving best practice care post-discharge, or reduces the odds of 30-day readmission and death; and whether being seen within 24 hours of admission by the respiratory team increases the odds of receiving best-practice care post-discharge, or reduces 30-day mortality.
Inappropriate hospital admission
- Avoidable hospital admission
- Best practice care of acute exacerbation of COPD post-discharge
- Readmission in the 30 days after discharge
- Death in the 30 days after discharge
- The 2017 National COPD Audit queries
Jennifer Quint - Chief Investigator - Imperial College London
Philip Stone - Corresponding Applicant - Imperial College London
Alex Bottle - Collaborator - Imperial College London
Johanna Feary - Collaborator - Imperial College London
Mike Roberts - Collaborator - Royal College Of Physicians - RCP
Noel Baxter - Collaborator - Royal College Of Physicians - RCP
Puja Myles - Collaborator - CPRD
Rebecca Ghosh - Collaborator - CPRD
Viktoria McMillan - Collaborator - Royal College Of Physicians - RCP
HES Accident and Emergency;HES Admitted Patient Care;ONS Death Registration Data;Patient Level Index of Multiple Deprivation;Other