Model to predict COPD hospital readmission developed

August 12, 2014

Researchers at the University of Texas Medical Branch at Galveston have identified predictors of early rehospitalization among patients hospitalized for complications of chronic obstructive pulmonary disease. This study was recently published in the Annals of the American Thoracic Society.

In a nationwide analysis of more than 8,000 commercially insured adult patients with COPD, UTMB researchers concluded that several modifiable factors, such as appropriate prescriptions upon discharge and early follow up after discharge from the hospital, were associated with lower likelihood of early readmission.

COPD is a major public health concern that affects 12 million to 24 million individuals and is the third leading cause of death in the United States. Each year, thousands of people have acute COPD flare-ups that require hospitalization. About 20 percent of these patients require readmission within 30 days of discharge.

High rates of hospital readmissions and differences in those rates may stem from patient-specific factors, including severity of COPD and the presence of other aggravating health conditions, factors related to and quality of care, as well as outpatient follow-up and availability of subspecialty referrals. These early readmissions result in overuse of resources and impose a heavy financial burden.

Reducing hospital readmissions has been an objective of the Affordable Care Act and Accountable Care Organizations. In 2009, the U.S. Centers for Medicare and Medicaid Services began to publicly report 30-day readmission rates for heart attacks, pneumonia and as a quality performance measure. In 2012, the CMS started to reduce Medicare payments to hospitals with high readmission rates for patients admitted with these conditions. Beginning in October 2014, COPD will be added to this list.

"This study analyzed a nationwide sample with robust design methods to confirm patient factors as a predictor of early readmission after initial hospitalization for COPD, as well as to show how a combination of different factors can independently contribute to early readmission," stated lead author Dr. Roozbeh Sharif. "Guideline-adherent management and early follow up has the potential to reduce early rehospitalization among COPD patients," added Sharif.

COPD patients with coexisting congestive heart failure, lung cancer, anxiety, depression or osteoporosis were associated with a higher likelihood of early readmission. Health care provider and system factors including prescriptions for bronchodilator inhalers, oral corticosteroids, antibiotics at discharge and an early outpatient follow up after discharge were associated with a lower likelihood of readmission.

This study suggests that strategies to reduce hospital readmissions shortly following COPD flare-ups are likely to be more effective when they extend beyond quality of COPD-specific care in the hospital.

The findings of this work have received international attention. It was presented at the World CHEST conference in Madrid, Spain in March 2014 and was quoted at the annual American Thoracic Society conference in May 2014.

Explore further: COPD readmission may be tied to unmodifiable risk factors

Related Stories

COPD readmission may be tied to unmodifiable risk factors

October 22, 2012
National efforts are underway to reduce 30-day readmission for chronic obstructive pulmonary disease (COPD); however, new research suggests that COPD readmissions may be related to risk factors that cannot be modified, including ...

One in six lupus patients readmitted to hospital within 30 days of discharge

August 11, 2014
A new study reveals that one in six patients with systemic lupus erythematosus (SLE) is readmitted to the hospital within 30 days of being discharged. Results published in Arthritis & Rheumatology, a journal of the American ...

Medicare patients with dementia 20 percent more likely to be readmitted

April 29, 2014
A review of more than 25,000 admissions of Medicare beneficiaries to Rhode Island hospitals has found that patients with a documented diagnosis of dementia are nearly 20 percent more likely to be readmitted within 30 days ...

Frequent in-person home visits can reduce both readmission and death for patients with heart failure

May 28, 2014
Home-visiting programs and multidisciplinary heart failure clinic interventions can reduce hospital readmission and improve survival for patients with heart failure, according to research from RTI International and the University ...

Physical activity associated with lower rates of hospital readmission in patients with COPD

April 9, 2014
Patients with chronic obstructive pulmonary disease (COPD) who participated in any level of moderate to vigorous physical activity had a lower risk of hospital readmission within 30 days compared to those who were inactive, ...

Study identifies risk factors for hospital readmissions

June 11, 2014
Hospital readmission, an important measure of quality care, costs the United States an estimated $17 billion each year. And according to the Centers for Medicare and Medicaid Services (CMS), about half of those readmissions ...

Recommended for you

Alcohol to claim 63,000 lives over next five years, experts warn

July 24, 2017
Alcohol consumption will cause 63,000 deaths in England over the next five years – the equivalent of 35 deaths a day – according to a new report from the University of Sheffield Alcohol Research Group.

Alcohol boosts recall of earlier learning

July 24, 2017
Drinking alcohol improves memory for information learned before the drinking episode began, new research suggests.

App lets patients work alone or with others to prevent, monitor, and reverse chronic disease

July 24, 2017
Lack of patient adherence to treatment plans is a lingering, costly problem in the United States. But MIT Media Lab spinout Twine Health is proving that regular interventions from a patient's community of supporters can greatly ...

To combat teen smoking, health experts recommend R ratings for movies that depict tobacco use

July 21, 2017
Public health experts have an unusual suggestion for reducing teen smoking: Give just about any movie that depicts tobacco use an automatic R rating.

Why sugary drinks and protein-rich meals don't go well together

July 20, 2017
Having a sugar-sweetened drink with a high-protein meal may negatively affect energy balance, alter food preferences and cause the body to store more fat, according to a study published in the open access journal BMC Nutrition.

Aging Americans enjoy longer life, better health when avoiding three risky behaviors

July 20, 2017
We've heard it before from our doctors and other health experts: Keep your weight down, don't smoke and cut back on the alcohol if you want to live longer.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.