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Patients with acute exacerbations of COPD or CHF who require readmission within 30 days have complex comorbidity. They appear to have typical clinical profiles (emphysematous-type COPD patients and CHF patients with fluid overload), are frequently discharged with suboptimal medication regimens, and are not referred to outpatient rehabilitation. These patients had frequent hospitalizations prior to index hospitalizations. This information provides the basis for a focused review of patients admitted to the hospital to identify factors that might contribute to readmission.