Respiratory-associated diseases have been shown to account for half of the reasons for readmissions, with chronic obstructive pulmonary disease (COPD) being among the most common diagnoses representing 27.6% of all readmissions (Shah et al., 2015). Patients that are discharged home without appropriate home care are more likely to be readmitted for COPD than patients discharged to post-acute care (Shah et al., 2015).
The reasons for such readmissions vary in the research literature; however, it has been found that accompanying diseases, previous health exacerbations and hospitalizations, as well as the prolonged length of stay, were significant risk factors for readmissions for COPD (Alqahtani et al., 2020). Thus, the problem is highly complex and multi-dimensional, requiring a systematic approach toward its resolution.
Today, several evidence-based models are used to improve the quality of care and reduce readmissions, although they are not COPD-specific. They include Project RED, Project BOOST, and the IDEAL Transition in Care Model. Drawing from the best practices from such models, it is possible to develop a comprehensive framework that is solely patient-focused, allowing to incorporate care for patients before readmissions take place. In addition to the emphasis on patient needs within care processes, the EBP framework for reducing COPD readmissions should also include bundled care incorporating EHR and patient education interventions to inform on inhaler use in addition to consistent follow-ups (Press et al., 2021).
Nevertheless, it must be noted that there is still no single EBP intervention that allows to reliably prevent hospital readmissions among COPD patients. Thus, more research is needed to identify best practices that positively influence readmission rates in this target population.
References
Alqahtani, J., Njoku, C., Bereznicki, B., Wimmer, B., Peterson, G., Kinsman, L., …Hurst, J. (2020). Risk factors for all-cause hospital readmission following exacerbation of COPD: a systematic review and meta-analysis. European Respiratory Review, 29, 190166. Web.
Anand, V., Garg, S., Koene, R., & Thenappan, T. (2018). Abstract 17286: National trends in hospital readmission rates in congestive heart failure patients. Circulation, 134(1). Web.
Press, V., Myers, L., & Feemster, L. (2021). Preventing COPD readmissions under the hospital readmissions reduction program: How far have we come? CHEST, 159(3), 996-1006. Web.
Shah, T., Churpek, M. M., Coca Perraillon, M., & Konetzka, R. T. (2015). Understanding why patients with COPD get readmitted: a large national study to delineate the Medicare population for the readmissions penalty expansion. Chest, 147(5), 1219-1226. Web.
Vader, J. M., LaRue, S. J., Stevens, S. R., Mentz, R. J., DeVore, A. D., Lala, A., Groarke, J. D., AbouEzzeddine, O. F., Dunlay, S. M., Grodin, J. L., Dávila-Román, V. G., & de Las Fuentes, L. (2016). Timing and causes of readmission after acute heart failure hospitalization-insights from the heart failure network trials. Journal of Cardiac Failure, 22(11), 875-883. Web.
Ziaeian, B., & Fonarow, G. C. (2016). The prevention of hospital readmissions in heart failure. Progress in Cardiovascular Diseases, 58(4), 379-385. Web.