Effects of post-discharge telemonitoring on 30-day chronic obstructive pulmonary disease readmissions and mortality

2020 ◽  
pp. 1357633X2097040
Author(s):  
Hanadi Y Hamadi ◽  
Dayana Martinez ◽  
Jing Xu ◽  
Geoffrey A Silvera ◽  
Jorge M Mallea ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Mortality Rates ◽  
Care Quality ◽  
Chronic Obstructive ◽  
Post Discharge ◽  
Obstructive Pulmonary Disease ◽  
American Hospital ◽  
American Hospital Association ◽  
Copd Mortality

Introduction Much attention has been focused on decreasing chronic obstructive pulmonary disease (COPD) hospital readmissions. The US health system has struggled to meet this goal. The objective of this study was to assess the efficacy of telehealth services on the reduction of hospital readmission and mortality rates for COPD. Methods We used a cross-sectional design to examine the association between hospital risk-adjusted readmission and mortality rates for COPD and hospital use of post-discharge telemonitoring (TM). Data for 777 hospitals were sourced from the Centers for Medicare & Medicaid Services and the American Hospital Association annual surveys. Propensity score matching using the kennel weights method was applied to calculate the weighted probability of being a hospital that offers post-discharge TM services. Results Hospitals with post-discharge TM had about 34% significantly higher odds (adjusted odds ratio (AOR) = 1.34; 95% confidence interval (CI) 1.06–1.70) of 30-day COPD readmission and 33% significantly lower odds (AOR = 0.67; 95% CI 0.50–0.90) of 30-day COPD mortality compared to hospitals without post-discharge TM services. Discussion Overall, hospitals that offer post-discharge TM services have seen an improvement in 30-day COPD mortality rates. However, those same hospitals have also experienced a significant increase in 30-day COPD readmissions. TM can potentially decrease mortality in patients recently admitted for acute exacerbation of COPD. The results provide further evidence that readmissions present a problematic assessment of health-care quality, as the need for readmission may or may not be directly related to the quality of care received while in hospital.

scholarly journals Mortality trends due to chronic obstructive pulmonary disease in Brazil

2014 ◽  
Vol 60 (3) ◽  
pp. 255-261 ◽  
Author(s):  
Gustavo Silveira Graudenz ◽  
Gabriel Pereira Gazotto
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Polynomial Regression ◽  
Functional Relation ◽  
Mortality Rates ◽  
Chronic Obstructive ◽  
Mortality Trends ◽  
Obstructive Pulmonary Disease ◽  
Increasing Trend ◽  
Copd Mortality

Objective: the purpose of this study was to update and analyze data on mortality trend due to chronic obstructive pulmonary disease (COPD) in Brazil. Methods: initially, the specific COPD mortality rates were calculated from 1989 to 2009 using data collected from DATASUS (Departamento de Informática do SUS - Brazilian Health System Database). Then, the polynomial regression models from the observed functional relation were estimated based on mortality coefficients and study years. Results: we verified that the general mortality rates due to COPD in Brazil showed an increasing trend from 1989 to 2004, and then decreased. Both genders showed the same increasing tendencies until 2004 and decreased thereafter. The age group under 35 years old showed a linear decreasing trend. All other age groups showed quadratic tendencies, with increases until the years of 1998-1999 and then decreasing. The South and Southeast regions showed the highest COPD mortality rates with increasing trends until the years 2001-2002 and then decreased. The North, Northeast and Central-West regions showed lower mortality rates but increasing trend. Conclusion: this is the first report of COPD mortality stabilization in Brazil since 1980.

scholarly journals Association between ambient fine particulate matters and chronic obstructive pulmonary disease (COPD) mortality: an analysis in Southeastern China

2020 ◽  
Author(s):  
Zhijian Chen ◽  
Qiuli Fu ◽  
Guangming Mao ◽  
Lizhi Wu ◽  
Peiwei Xu ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Mixed Model ◽  
Fine Particles ◽  
Chronic Obstructive ◽  
Particulate Matters ◽  
Southeastern China ◽  
Obstructive Pulmonary Disease ◽  
Adverse Health Effects ◽  
Copd Mortality

Abstract Background: The objective of this study was to investigate the association between ambient particulate matters(PMs)and chronic obstructive pulmonary disease (COPD) mortality.Methods: Generalized Additive Mixed Model was employed to investigate the effects of ambient fine and coarse PMs on COPD mortality using 13,066 deaths from 2014 to 2016 among six cities in Zhejiang Province in Southeastern China.Results: The daily average death count due to COPD was 3, varying from 1 to 7among six cities. The daily 24-hour mean concentrations were diverse among cities, from 29.7 to 56.8 µg/m3 for PM2.5, 16.7 to 30.3 µg/m3 for PM2.5−10, and 50.3 to 87.1 µg/m3 for PM10, respectively. The analysis showed that daily exposure to PM2.5 and PM10 was associated with increased mortality due to COPD and that weak effects were observed between PM2.5−10 and COPD mortality.Conclusions: Our results provided evidence that the fine particles in air pollution have stronger functions on adverse health effects other than coarser particles in Southeastern China, which may be considered as a potential clinic target in PM-associated COPD.

scholarly journals Mortality of Elderly Patients in Ontario after Hospital Admission for Chronic Obstructive Pulmonary Disease

2007 ◽  
Vol 14 (8) ◽  
pp. 485-489 ◽  
Author(s):  
Jason X Nie ◽  
Li Wang ◽  
Ross EG Upshur
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
General Practitioner ◽  
Elderly Patients ◽  
Hospital Admission ◽  
Pulmonary Disease ◽  
Family Physician ◽  
Mortality Rates ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Significant Mortality

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is associated with significant mortality. It is currently the fourth leading cause of death in Canada and the world.OBJECTIVES: To describe the mortality of elderly patients in Ontario after hospital admission for COPD.METHODS: A retrospective cohort study was conducted using the Discharge Abstract Database from the Canadian Institute for Health Information. Patients aged 65 years and older who were admitted to hospital between 2001 and 2004 with primary discharge diagnoses labelled with International Classification of Diseases, Ninth Revision codes 491, 492 and 496 were included in the study.RESULTS: Mortality rates were 8.81, 12.10, 14.53 and 27.72 per 100 COPD hospital admissions at 30, 60, 90 and 365 days after hospital discharge, respectively. Mortality also increased with age, and men had higher rates than women. No significant differences in mortality rates were found between different socioeconomic groups (P>0.05). Patients with shared care of a family physician or general practitioner and a specialist had significantly lower mortality rates than the overall rate (P<0.05), and their rates were approximately one-half the rate of patients with only one physician.CONCLUSIONS: Hospitalization with COPD is associated with significant mortality. Patients who were cared for by both a family physician or general practitioner and a specialist had significantly lower mortality rates than those cared for by only one physician, suggesting that continuous and coordinated care results in better survival.

scholarly journals Mortality among Subjects with Chronic Obstructive Pulmonary Disease or Asthma at Two Respiratory Disease Clinics in Ontario

2011 ◽  
Vol 18 (6) ◽  
pp. 327-332 ◽  
Author(s):  
Murray M Finkelstein ◽  
Kenneth R Chapman ◽  
R Andrew McIvor ◽  
Malcolm R Sears
Keyword(s):  
Risk Factors ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Respiratory Disease ◽  
Mortality Rates ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Risk Of Death ◽  
Severity Scores ◽  
Standardized Mortality Ratios

BACKGROUND: Chronic obstructive pulmonary disease (COPD) and asthma are common; however, mortality rates among individuals with these diseases are not well studied in North America.OBJECTIVE: To investigate mortality rates and risk factors for premature death among subjects with COPD.METHODS: Subjects were identified from the lung function testing databases of two academic respiratory disease clinics in Hamilton and Toronto, Ontario. Mortality was ascertained by linkage to the Ontario mortality registry between 1992 and 2002, inclusive. Standardized mortality ratios were computed. Poisson regression of standardized mortality ratios and proportional hazards regression were performed to examine the multivariate effect of risk factors on the standardized mortality ratios and mortality hazards.RESULTS: Compared with the Ontario population, all-cause mortality was approximately doubled among subjects with COPD, but was lower than expected among subjects with asthma. The risk of mortality in patients with COPD was related to cigarette smoking, to the presence of comorbid conditons of ischemic heart disease and diabetes, and to Global initiative for chronic Obstructive Lung Disease severity scores. Individuals living closer to traffic sources showed an elevated risk of death compared with those who lived further away from traffic sources.CONCLUSIONS: Mortality rates among subjects diagnosed with COPD were substantially elevated. There were several deaths attributed to asthma among subjects in the present study; however, overall, patients with asthma demonstrated lower mortality rates than the general population. Subjects with COPD need to be managed with attention devoted to both their respiratory disorders and related comorbidities.

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