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Study Evaluates Impact of Care Management Programs on COPD Readmission Rates

Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is one of the leading causes of hospitalization in the U.S. Due to the condition's significant financial and health burdens, healthcare organizations and government agencies throughout the nation are striving to reduce its frequency.

A recent study published in the American Journal of Managed Care analyzed both the clinical and psychosocial risk factors associated with readmissions for COPD exacerbations, with a focus on patients treated at Danbury Hospital, an academic community hospital which implemented a comprehensive care management program (CCMP) and chronic obstructive pulmonary disease (COPD) readmission reduction initiative. An exacerbation was defined as increased cough, sputum or dyspnea in a patient with COPD, as well as a change in sputum color.

“The Agency for Healthcare Research and Quality estimates that 1 out of every 5 patients over the age of 40 who have been hospitalized in the past decade carries a diagnosis of COPD,” noted the study. “Given its prevalence in hospitalized patients, COPD and its acute exacerbation pose a heavy financial burden in health care.”

Throughout the study, researchers collected data on patients with AECOPD, which included an assessment of their clinical comorbidities, such as pneumonia, cognitive disorders and smoking status. Patients' psychosocial risk factors, including anxiety, home safety, and access to transportation, were also analyzed. It was revealed that out of 272 patients, 20 were readmitted within 30 days of their index hospitalization.

Those who were readmitted had a higher rate of pneumonia at readmission and were more likely to have safety issues at home, anxiety and lack of transportation. There was no significant difference between those who were readmitted and those who were not in regard to their age, smoking status, gender or body mass index (BMI). Research also revealed that after one-year post implementation of the CCMP, the hospital's annual readmission rate decreased from 21.5 percent to 13.6 percent.

“From a community hospital that has successfully reduced readmissions for AECOPD after implementation of our CCMP, we speculate that a CCMP can reduce readmission rates with careful execution of a program that includes optimization of in-hospital care, better coordination of pre- and post-discharge care, attention to social variables, a system to better identify patient problems after discharge, and an office setup that can accommodate same day sick visits,” concluded the study.

Click Here to Access the Full Article in the American Journal of Managed Care