Abstract
The aim of this paper is to model the length of stay following hospital emergency due to asthma and chronic obstructive pulmonary disease (COPD) as well as those factors relating to its duration. Clinical records of all those hospital emergencies for asthma and COPD in people aged over 14 at the Hospital Clinico Universitario of Valencia (HCUV) during years 1993–1995 were reviewed. Data were analysed by entry and discharge time, sex, age and destination. Parametric survival models (exponential, Weibull and log-normal) were used for each diagnostic. Percentiles and relative percentiles were calculated; 1369 asthma emergencies and 2734 cases COPD were observed. The mean length of stay was 5.21 hours for asthma and 6.32 for COPD log-normal model was the best parametric model. Lengths of stay are greater for those hospital admitted. Stays, in cases of asthma, were shorter during months of August and November, with no differences for other variables. Also a shorter duration of stay for the month of August was found. Women are seen to stay for longer periods than men. Time modelling of emergency admission for asthma and COPD permits its use in the determining of the dates of incidence for episodes of asthma and COPD based on hospital admissions data, as seeing a median of delay in emergency rooms greater than 6 hours. For studies on air pollution impact these results imply that all those admissions during the early hours of the morning should be categorised as events of the previous day.
Similar content being viewed by others
References
Schwartz J. Air pollution and daily mortality: A review and metaanalysis. Environ Res 1994; 64: 36-52.
The APHEA project. Short term effeects of air pollution on health: A European approach using epidemiological time series data. J Epidemiol Comm Health 1996; 50(Suppl 1): S2-S80.
Sunyer J, Anto JM, Murillo C, Saez M. Effeects on urban air pollution on emergency room admissions for chronic obstructive pulmonary disease. Am J Epidemiol 1991; 134: 277-286.
Sunyer J, Saez M, Murillo C, Castellsague J, Martínez F, Anto JM. Air pollution and emergency room admissions for chronic obstructive pulmonary disease: A 5 year study. Am J Epidemiol 1993; 137: 705.
Schwartz J, Slater D, Larson TV, Pierson WE, Koening JQ. Particulate air pollution and hospital emergency room visits for asthma in Seattle. Am Rev Respir Dis 1993; 147: 826-831.
Poènka A. Asthma and low level air pollution in Helsinki. Arch Environ Health 1991; 46: 262-270.
Thurston GD, Ito K, Kinney PL, Lippmann M. A multi-year study of air pollution and respiratory hospital admissions in three New York State metropolitan areas: Results for 1988 and 1989 summers. J Expos Anal Environ Epidemiol 1992; 2: 429-450.
Diaz-Caneja N, Gutièrrez I, Martínez A, Matorras P, Villar E. Multivariate analysis of the relationship between meteorological and pollutant variables and the number of hospital admissions due to cardio-respiratory diseases. Environ Int 1991; 17: 397-403.
Walter S, Griffiths RK, Ayres JG. Temporal association between hospital admissions for asthma in Birmingham and ambient pollution levels. Thorax 1994; 49: 133-140.
Barber P, Gonzalez B. Simulación de una unidad hospitalaria de urgencias y su uso potencial para la gestión. Gaceta Sanitaria 1994; 8: 239-247.
McGuire FSO. Using simulation to reduce length of stay in emergency departments. J Soc Health Syst 1997; 5: 81-90.
Anonymous Hospital Clínic Universitari. Hospital Malvarosa. Memória 1991-1994. Valencia: Generalitat Valenciana. Conselleria de Sanitat i Consum, 1995.
Martínez F, Sunyer J, Anto JM. Reliability of a monitoring system for respiratory emergency room admissions. Eur Respir J 1993; 6: 337-341.
Merelles T. Estudio de fiabilidad y válidez en la identificación de asthma y EPOC en el Servicio de Urgencias del Hospitald Clínico Universitario de Valencia. Valencia: Institut Valencià d'Estudis en Salut PÚblica (IVESP), 1996.
Pèrez-Hoyos S. Análisis de Supervivencia. Valencia: Institut Valenciá d'Estudis en Salut PÚblica, 1997.
Statistical Sciences I. S-plus User's Manual: Version 3.3 for Windows. Seattle, Washington: Statistical Sciences Inc, 1995.
Ballester F, Pèrez-Hoyos S, Rivera ML, et al. Patrones de frecuentación y factores asociados al ingreso en el hospital de las urgencias hospitalarias por asam y por enfermedad pulmonar obstructiva crónica. Arch Bronconeumol 1999; 35: 20-26.
Ruiz-T, Ronda-E, Alvarez-Dardet-C, Gil-V, Belda-J. El genero del paciente en los servicios de urgencias: diferente o desigual? Gac-Sanit 1995; 9: 76-83.
Balanzó X, Pujol R. Grupo Intercomarcal de Medicina Interna: Estudio Multicè ntrico de las urgencias en hospitales generales básicos de Catalunya. Med Clin (Barc) 1989; 92: 86-90.
Delfino RJ, Becklake MR, Hanley JA. Reliability of hospital data for population-based studies of air pollution. Arch Environ Health 1993; 48: 140-146.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Pérez-Hoyos, S., Ballester, F., Tenías, J. et al. Length of stay in a hospital emergency room due to asthma and chronic obstructive pulmonary disease: Implications for air pollution studies. Eur J Epidemiol 16, 455–463 (2000). https://doi.org/10.1023/A:1007631609827
Issue Date:
DOI: https://doi.org/10.1023/A:1007631609827