A Picture of COPD Readmitted Patients

Virginia’s hospitals admitted 54,477 patients for chronic obstructive lung disease (COPD) between the fourth quarter of 2013 and the third quarter of 2015. Of those patients, 8,265 (or 15 percent of COPD patients) people returned to the hospital within 30 days. Among COPD patients who return to the hospital, 90 percent return through the emergency room. Unlike other chronic diseases, hospitalized COPD patients tend to be comparatively young. Their average age is 67; the average age of those COPD patients who are readmitted is 68. A previous Research Corner noted that COPD is one of the two diseases with high morbidity and mortality effects, meaning it contributes to significant disability and shortened lifespan. As with other chronic diseases tracked through the Value Based Purchasing effort by the Centers for Medicare & Medicaid Services (CMS), readmissions for COPD tend to occur fairly quickly. As Figure 1 shows, the most common period for admissions is two to four days after discharge. The strongest predictor that COPD patients will be readmitted is a history of requiring mechanical ventilation (Odds Ratio of 2.5). The next strongest predictor is a history of congestive heart failure (Odds Ratio of 1.40). Those two factors frequently coexist in patients. COPD is a chronic disease that is often accompanied by congestive heart failure. Since readmissions tend to occur quickly, a strong discharge planning effort, including quick access to a provider to address shortness of breath, presents key opportunities for reducing readmissions. (5/6)

Figure 1. Day of readmission for COPD patients discharged from Virginia hospitals