Researchers identify early predictors of rehospitalization in patients with COPD -
Researchers at the University of Texas Medical Branch at Galveston have identified predictors in early readmission patients hospitalized for chronic obstructive pulmonary disease complications. This study was recently published in Annals of the American Thoracic Society .
In a nationwide analysis of over 8,000 patients commercially insured adults with COPD, the UTMB researchers concluded that several modifiable factors, such requirements as applicable on the discharge and follow soon after the hospital discharge were associated with lower likelihood of early readmission.
COPD is a major public health problem that affects 12 to 24 million people and is the third leading cause of death in the United States. Each year, thousands of people have outbreaks of acute COPD requiring hospitalization. About 20 percent of these patients require readmission within 30 days of discharge.
High rates of hospital readmissions and differences in rates can result from factors specific patient, including the severity of COPD and the presence of other aggravating health problems, factors from health-care providers and the quality of care and monitoring outpatient and availability of reference subspecialty. These early readmissions lead to overuse of health care resources and impose a heavy financial burden.
hospital readmissions reduction has been a goal of the Affordable Care Act and accountable care organizations. In 09, the US Centers for Medicare and Medicaid Services began publicly report the 30-day readmission rates for heart attacks, pneumonia and congestive heart failure, quality performance measurement. In 2012, CMS began to cut Medicare payments to hospitals with high readmission rates for patients admitted to these conditions. Since October 2014, COPD will be added to this list.
"This study analyzed a national sample with robust design methods for confirming patient factors as an early readmission predictor after first hospitalization for COPD, as well as to show how a combination of different factors may independently contribute to early readmission, "said lead author Dr. Roozbeh Sharif. "Managing Director-stick line and early monitoring has the potential to reduce early rehospitalization among patients with COPD," said Sharif.
COPD patients with co-existing congestive heart failure, lung cancer, anxiety, depression or osteoporosis was associated with a higher probability of early readmission. health care provider and system factors, including the requirements for inhaler bronchodilators, oral corticosteroids, antibiotics and discharge the early outpatient follow-up after discharge were associated with a lower likelihood of readmission.
This study suggests that strategies to reduce readmissions shortly after hospital COPD flare-ups are likely to be most effective when they go beyond the quality of care specific to COPD in 'hospital.
The results of these works have received international attention. It was presented at the World Conference CHEST in Madrid, Spain in March 2014 and was quoted at the annual conference of the American Thoracic Society in May 2014.
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