Retrospective Review of the Impact of a Chronic Obstructive Pulmonary Disease (COPD) Comprehensive Case Program on Hospital Readmission Rates

CHEST Journal ◽  
2015 ◽  
Vol 148 (4) ◽  
pp. 715A
Author(s):  
Abdulmajeed Alshabanat ◽  
Carmen Rampel ◽  
Jane Burns ◽  
Don Sin ◽  
Jeremy Road ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Retrospective Review ◽  
Hospital Readmission ◽  
Chronic Obstructive ◽  
Readmission Rates ◽  
Obstructive Pulmonary Disease ◽  
Hospital Readmission Rates ◽  
The Impact

scholarly journals Predictors of hospital admission and mortality in patients with chronic obstructive pulmonary disease

2001 ◽  
Vol 11 (1) ◽  
pp. 99-106 ◽  
Author(s):  
AM Yohannes ◽  
MJ Connolly
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Hospital Readmission ◽  
Chronic Obstructive ◽  
Readmission Rates ◽  
Obstructive Pulmonary Disease ◽  
Hospital Readmission Rates ◽  
Copd Patients ◽  
Impaired Quality

Hospital readmission rates for COPD patients are high, with two-week readmission rates of 22% being recorded in one study of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). In a separate study, patients admitted with PaCO2> 50 mm Hg had a readmission rate of 40% at six months. There are no agreed clinical evidence factors that determine readmission. A few studies have reported that readmission is associated with an individual’s inability to cope with the disease, and that anxiety and socioeconomic status are important variables. Others argue that readmission relates to severity of lung function abnormality, changes in atmospheric pollution, and impaired quality of life (QoL).

scholarly journals Risk Factors and Outcomes Associated with Chronic Obstructive Pulmonary Disease Exacerbations Requiring Hospitalization

2009 ◽  
Vol 16 (4) ◽  
pp. e43-e49 ◽  
Author(s):  
Katayoun Bahadori ◽  
J Mark FitzGerald ◽  
Robert D Levy ◽  
Tharwat Fera ◽  
John Swiston
Keyword(s):  
Risk Factors ◽  
Chronic Obstructive Pulmonary Disease ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Pulmonary Disease ◽  
Logistic Regression Analysis ◽  
Hospital Readmission ◽  
Chronic Obstructive ◽  
Readmission Rates ◽  
Obstructive Pulmonary Disease

BACKGROUND: Acute respiratory exacerbations are the most frequent cause of medical visits, hospitalization and death for chronic obstructive pulmonary disease (COPD) patients and, thus, exert a significant social and economic burden on society.OBJECTIVE: To identify the risk factors associated with hospital readmission(s) for acute exacerbation(s) of COPD (AECOPD).METHODS: A review of admission records from three large urban hospitals in Vancouver, British Columbia, identified 310 consecutive patients admitted for an AECOPD between April 1, 2001, and December 31, 2002. Logistic regression analysis was performed to identify risk factors for readmissions following an AECOPD.RESULTS: During the study period, 38% of subjects were readmitted at least once. The mean (± SD) duration from the index admission to the first readmission was 5±4.08 months. Comparative analysis among the three hospitals identified a significant difference in readmission rates (54%, 36% and 18%, respectively). Logistic regression analysis revealed that preadmission home oxygen use (OR 2.55; 95%CI 1.45 to 4.42; P=0.001), history of a lung infection within the previous year (OR 1.73; 95% CI 1.01 to 2.97; P=0.048), other chronic respiratory disease (OR 1.78; 95% CI 1.06 to 2.99; P=0.03) and shorter length of hospital stay (OR 0.97; 95% CI 0.945 to 0.995; P=0.021) were independently associated with frequent readmissions for an AECOPD.CONCLUSIONS: Hospital readmission rates for AECOPD were high. Only four clinical factors were found to be independently associated with COPD readmission. There was significant variability in the readmission rate among hospitals. This variability may be a result of differences in the patient populations that each hospital serves or may reflect variability in health care delivery at different institutions.

scholarly journals Structured Training to the Patients of Chronic Obstructive Pulmonary Disease Reduces Frequency of Hospital Readmission

2018 ◽  
Vol 6 (1) ◽  
pp. 35-44
Author(s):  
Md Mizanur Rahman ◽  
MA Azhar ◽  
Anup Kumar Saha ◽  
Kamrun Nahar
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Hospital Stay ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Hospital Readmission ◽  
Smoking Status ◽  
Chronic Obstructive ◽  
Case Group ◽  
Obstructive Pulmonary Disease ◽  
The Impact

Background: Patient education after treatment of acute exacerbation in patients with chronic obstructive pulmonary disease (COPD) prevents frequent hospital readmission and improve quality of life.Objectives: To observe the impact of providing structured training to patients of COPD on repeated hospital admission.Materials and method: This prospective comparative study was carried out in the inpatient department of Medicine and Pulmonology Unit, Sir Salimullah Medical College and Mitford Hospital, Dhaka, Bangladesh, from January 2010 to June 2011. A total of 144 admitted patients with COPD with an attack of acute exacerbation were included in this study without having any significant or chronic comorbidity. Of the 144 patients, 72 were randomly allocated for receiving structured training (cases; Group-A) and the rest 72 patients did not receive the training (controls; Group-B).Results: The pertinent demographic characteristics, smoking status, and knowledge about different aspects of COPD, and medications used during acute exacerbation of COPD before intervention were almost similar between the groups. Over 30% of the patients who received structured training needed no hospital admission, 58.3% needed only one and 11.1% needed 2 or more admissions, while the other group required two or more admissions during the same period (p < 0.001). The duration of hospital stay was significantly less in case group. Number of > 2 consultations with physicians was significantly higher in the former group (26.4% vs. 6.9%) (p = 0.002), indicating an increased awareness on the part of that group.Conclusion: Structured training to COPD patients significantly reduced hospitalization and hospital stay for an acute exacerbation in this study.Delta Med Col J. Jan 2018 6(1): 35-44

scholarly journals Evaluation of Bronchodilator Use During Chronic Obstructive Pulmonary Disease Exacerbation Inpatient Admissions

2018 ◽  
Vol 54 (2) ◽  
pp. 112-118 ◽  
Author(s):  
Sarah E. Petite ◽  
Julie A. Murphy
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Hospital Admission ◽  
Pulmonary Disease ◽  
Readmission Rate ◽  
Hospital Setting ◽  
Chronic Obstructive ◽  
Copd Exacerbation ◽  
Readmission Rates ◽  
Obstructive Pulmonary Disease ◽  
The Impact

Background: It is unknown whether the timing of initiation of a long-acting bronchodilator (LABD) during a chronic obstructive pulmonary disease (COPD) exacerbation or the method of short-acting bronchodilator (SABD) delivery may aid in improving patient outcomes. Objective: The goal of this study was to determine the impact of bronchodilator management in the hospital setting on clinical outcomes in patients with COPD exacerbation. Methods: This retrospective, single-center study evaluated patients admitted to the non-intensive care unit setting with a COPD exacerbation as defined by the International Classification of Diseases, Ninth Revision codes. The primary outcome was difference in 30-day readmission rates for early LABD therapy (<24 hours from hospital admission) versus late/no LABD therapy (>24 hours from hospital admission or not during hospitalization). Secondary objectives included length of stay (LOS) for this group, and 30-day readmission rates and LOS for the SABD via inhaler versus nebulizer groups. Results: Two hundred twenty patients were included. There was no difference in 30-day readmission rate (15.2% vs 18.2%, P = .6) and LOS (median 4 [interquartile range, IQR 3-6]) days for both groups, P = .34) between early versus late/no LABD therapy initiation, respectively. No difference was observed in 30-day readmission rate (16.7% vs 16.6%) and LOS (median 2.5 [IQR 1.1-3.9] days vs median 4 [IQR 2-6] days) between inhaler and nebulizer SABD therapy groups. Conclusions: No difference was observed in 30-day readmission rates or LOS when utilizing early LABD compared with late/no LABD therapy or comparing inhaler and nebulizer SABD delivery methods during COPD exacerbation.

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