Major Health Care Burden Identified for 30-Day Acute Exacerbations Readmissions

Medicaid coverage, lower household income, and higher comorbidity burden are all patient-level predictors of early hospital readmission following an acute exacerbation of chronic obstructive pulmonary disease (COPD), according to a study published in the Annals of the American Thoracis Society.

“Understanding the causes and factors related to readmission for an acute exacerbation of chronic obstructive pulmonary disease within a nationwide database including all payers and ages can provide valuable input for the development of generalizable readmission reduction strategies,” researchers wrote.

The study tapped the US Nationwide Readmission Database to identify more than 1 million hospital admissions for acute exacerbations of COPD in 2013 and 2014. Researchers identified a 30-day readmission rate of 19.2%.

Some 58% of readmissions occurred within 15 days of discharge, with the highest readmission rates (up to 5.5%) taking place within the first 72 hours after discharge. The most common readmission reason was respiratory-based disease, which prompted 52.4% of the readmissions. COPD was the most common diagnosis, according to the study, at 28.4%.

In addition to patient-level factors associated with early readmission, the study identified 2 particular clinical factors linked with 30-day readmission: longer length of stay and discharge to a skilled nursing facility.

“Thirty-day readmissions after an acute exacerbation of COPD remain a major healthcare burden,” researchers wrote. “Development of a COPD-specific risk stratification algorithm based on these factors may be necessary to better predict patients … at high risk of early readmission.”

—Jolynn Tumolo

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