A group of investigators from the University of Texas Medical Branch in Galveston were recently able to identify certain factors that are linked to quick readmission of chronic obstructive pulmonary disease (COPD) patients in hospitals. Their findings are currently available in the Annals of the American Thoracic Society, entitled, “Predictors of Early Readmission among Patients 40 to 64 Years of Age Hospitalized for Chronic Obstructive Pulmonary Disease.”
The researchers enrolled over 8,000 participants from across the country, and found that a number of modifiable factors (i.e. relevant discharge prescriptions and prompt follow up appointments) were linked to lesser incidences of readmission.
COPD has been classified as one of the country’s primary public health concerns, with between 12-24 million Americans diagnosed with the disease, and it is the third major cause of mortality in the country. Every year, several thousand individuals experience an exacerbation of COPD that leads to a readmission into a healthcare facility. Approximately 20% of them experience a readmission within a month from prior discharge from the hospital.
The study followed more than 8,000 adult patients who were diagnosed with COPD, between the ages of 40 and 64 years with commercial insurance, and who had been hospitalized for the disease. Of this group, 741 (8.9%) were found to have been readmitted to a hospital soon after their initial discharge. Key factors in the readmission cases of those identified in the study included the facts that health providers had not prescribed statins within a year of the patient’s first hospitalization for COPD, nor were these readmitted patients given access to a short-acting bronchodilator, oral steroids, or antibiotics during their first hospital discharge. In addition, patients with a quick readmission were found to have not been followed up with by a doctor after discharge.
As a result, some of the factors associated with these high numbers of readmissions were identified as the following: acuteness of COPD and existence of other compounding diagnoses, quality of health care rendered, promptness of and compliance to outpatient follow up appointments, and accessibility of subspecialty referrals. The study underscores the need to minimize hospital readmissions, as they constitute a major financial problem for patients and their significant others.
The Affordable Care Act and Accountable Care Organizations has been working towards minimizing hospital readmissions. In 2009, the U.S. Centers for Medicare and Medicaid Services initiated filing public reports on health facilities’ 30-day readmission rates for conditions such as heart attacks, pneumonia, and congestive heart failure as a means of monitoring quality of healthcare. Two years ago, the CMS mandated a reduction in Medicare payouts to facilities with substandard readmission rates. This year, in October, CMS will be adding COPD to these monitored conditions.
Since its publication, this study has received a number of recognitions from across the globe. Earlier this year in March, the researchers were invited to present it in Madrid, Spain during the World CHEST conference. Later in May, it was quoted during the American Thoracic Society.
Similarly on COPD, a group of researchers from Kaiser Permanente Southern California Department of Research & Evaluation found that readmission rates were significantly lower among patients that engaged in regular physical activity. Click here to find out more.