Health Care Utilisation and Health Needs of People with Severe COPD in the Southern Region of New Zealand: A Retrospective Case Note Review

Jack Dummer, Emma Tumilty, Debbie Hannah, Kathryn McAuley, Jo Baxter, Fiona Doolan-Noble, Simon Donlevy, Tim Stokes

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


We examined health care utilisation and needs of people with severe COPD in the low-population-density setting of the Southern Region of New Zealand (NZ). We undertook a retrospective case note review of patients with COPD coded as having an emergency department attendance and/or admission with at least one acute exacerbation during 2015 to hospitals in the Southern Region of NZ. Data were collected and analysed from 340 case notes pertaining to: demographics, hospital admissions, outpatient contacts, pulmonary rehabilitation, advance care planning and comorbidities. Geometric mean (95%CI) length of stay for hospital admissions in urban and rural hospitals was 3.0 (2.7-3.4) and 4.0 (2.9-5.4) days respectively. More patients were from areas of higher deprivation but median hospital length of stay for patients from the least deprived areas was 2.0 days longer than others (p = 0.04). There was a median of 4 (range 0-16) comorbidities and 10 medications (range 0-25) per person. Of 169 cases where data was available, 26 (15%) were offered, 17 (10%) declined, and 5 (3%) completed, pulmonary rehabilitation at or in the year prior to the index admission. Patients were less likely to be offered pulmonary rehabilitation if they lived >20km away from the hospital where it took place (odds ratio of 0.12 for those living further away [95%CI 0.02-0.93, p = 0.04]). There were deficits in care: provision and uptake of non-pharmacological interventions was suboptimal and unevenly distributed across the region. Further research is needed to develop and evaluate strategies for delivering non-pharmacological interventions in this setting.

Original languageEnglish (US)
Pages (from-to)136-142
Number of pages7
JournalCOPD: Journal of Chronic Obstructive Pulmonary Disease
Issue number2
StatePublished - Mar 3 2020
Externally publishedYes


  • Chronic obstructive pulmonary disease
  • health systems service delivery
  • pulmonary rehabilitation

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine


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