Length of ICU stay for chronic obstructive pulmonary disease varies among large community hospitals

Objective: To determine whether differences exist among large community hospitals in length of Intensive Care Unit (ICU) stay, hospital stay or hospital mortality for patients admitted to ICU and whose most responsible diagnosis was chronic obstructive pulmonary disease (COPD). Design: Retrospective cohort study. Setting: All seven large community hospitals in British Columbia, Canada. Patients: All 296 patients who were admitted to ICUs and whose most responsible diagnosis was COPD during the 3 fiscal years 1994-1997. Interventions: None. Measurements and main results: After adjusting for age, gender, case-mix group, and co-morbidity, we found a significant difference in length of ICU stay for these patients among hospitals (P <0.03). No differences were found in hospital mortality or length of hospital stay for the same patients among the same hospitals. Conclusions: There is significant variation in length of ICU stay for patients who are admitted to ICU and whose most responsible diagnosis is COPD, among large community hospitals. These small area variations may point to opportunities to improve efficiency of care. Further prospective, detailed data collection is required to validate these observations and to identify factors responsible for any differences found.