Chronic breathlessness, a symptom often overlooked by healthcare systems, is associated with longer lengths of hospital stay on already overstretched healthcare resources, says new Flinders University research.
A new study, published in the Australian Health Review, highlights an urgent need for clinicians and policymakers to recognise chronic breathlessness as a major driver of hospital admissions and healthcare costs.
Historically, health systems have focused on sudden, short-term episodes of breathlessness (acute breathlessness), leaving millions of people living with recurring breathlessness (chronic breathlessness) underdiagnosed and undertreated, despite its profound impact on daily life.
Lead author, Professor David Currow, Strategic Professor at the Flinders Ageing Alliance, says at least one in 300 Australians is housebound or struggles with basic tasks such as dressing because of chronic breathlessness.
"Chronic breathlessness affects every aspect of life, contributing to disability, anxiety, depression, and reduced workforce participation," says Professor Currow.
"People often adapt by avoiding exertion, which leads to further physical decline. Yet this symptom remains largely invisible in clinical consultations, often dismissed as an inevitable part of illness rather than a treatable condition."
The study analysed data from nearly 12,000 patients and found that the severity of chronic breathlessness recorded in general practice predicts two critical outcomes: a shorter time to the next unplanned hospital admission; and longer length of stay once admitted.
This helps explain some previously unexplained variations in length of hospital stays, even after accounting for demographic, clinical, and system factors.
"Longer hospital stays increase costs, reduce bed availability, and intensify emergency department pressures," says Professor Currow.
"In Australia alone, chronic breathlessness is estimated to cost more than $12 billion annually in healthcare and societal expenses, a figure expected to rise with an ageing population and increasing rates of chronic illness.
"Chronic breathlessness is not just a symptom, it's a major health challenge. By recognising and managing it more effectively, we can improve quality of life. Understanding the drivers for these longer lengths of stay is a critical next step."
The study outlines four priority actions:
- Routine screening: Health professionals should ask about chronic breathlessness, not just acute symptoms, and consider making it the 'sixth vital sign' in emergency and inpatient settings.
- Accurate reporting: Medical administrators should ensure chronic breathlessness is properly recorded for better data collection.
- Early intervention research: Future studies should explore whether early management in primary care can reduce unplanned admissions.
- Hospital process review: Investigate why patients with chronic breathlessness experience longer stays, including potential delays at admission or discharge.
The article, 'Chronic breathlessness is associated with much longer lengths of hospital stay' by David Currow, Slavica Kochovska, Rachael Evans (University of Leicester, UK), Janelle Yorke (The Hong Kong Polytechnic University, Hong Kong) and Patricia M. Davidson (University of New South Wales) was published in Australian Health Review. DOI: 10.1071/AH25253
