One of the major causes of mortality and morbidity is a chronic obstructive pulmonary disease (COPD). Among patients diagnosed with COPD, 10% to 20% of people are readmitted within 30 days (Simmering et al., 2016). This category of patients is at greater risk of mortality and displays worse outcomes in relation to those that are not re-hospitalized. Currently, interprofessional care is one of the main interventions addressing COPD readmission. Specifically, COPD Coordinated Access to Reduce Exacerbation (CARE) is implemented to reduce the associated risks (Portillo et al., 2018).
Patients after discharge are directed to COPD CARE if they had exacerbation of COPD. The patients were identified through telephone contact or ICD-10 diagnosis, or chart review (Portillo et al., 2018). The service allows some leeway for pharmacists to prescribe necessary medication and schedules PCP visits if necessary. Although the data for the CARE is limited positive results of the intervention are promising. Access to care was achieved in 14 out of 19 patients and 12 of the “no longer needed to see their PCP following discharge” (Portillo et al., 2018). Therefore, its large-scale implementation should be encouraged for the effective reduction of readmission.
In COPD care, the measurement of care performance is the readmission within the time frame of 30 days from the first hospitalization. The study of Simmering et al. (2016) examined the risk for such readmission and found that people in their 40s or older are prone to readmission. The data suggests that the age group of 40-64 demonstrate the highest readmission rates of “14.77% for Medicare and 16.27% for Medicaid” among 17,918,374 patients in 480 hospitals (Simmering et al., 2016, p. 729).
The authors speculate that it might be possible that the primary source for the data was affected by the survivor bias, which led to the diminishment of the prevalent data. Moreover, it seems that the payer status also has an effect at reducing the chances for readmission as younger patients with private insurance had a 38% lower chance for readmission in comparison to patients on Medicare (Simmering et al., 2016). Patients on private insurance are likely to have partners that are able to provide quality at-home care
References
Portillo, E. C., Wilcox, A., Seckel, E., Margolis, A., Montgomery, J., Balasubramanian, P.,… & Kakumanu, S. (2018). Reducing COPD readmission rates: Using a COPD care service during care transitions. Federal practitioner, 35(11).
Simmering, J. E., Polgreen, L. A., Comellas, A. P., Cavanaugh, J. E., & Polgreen, P. M. (2016). Identifying patients with COPD at high risk of readmission. Chronic Obstructive Pulmonary Diseases, 3(4), 729-738. Web.