The Association Between Hospital Readmission and Pulmonologist Follow-up Visits in Patients With COPD

Gavish, Rachel; Levy, Amalia; Dekel, Or Kalchiem; Karp, Erez; Maimon, Nimrod

doi:10.1378/chest.14-1453

Cited by 82 publications

(52 citation statements)

References 11 publications

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“…A follow-up visit was associated with a protective effect against emergency readmissions in the study by Sin et al,37 which showed a 23% reduction in risk of emergency readmissions. On the other hand, lack of follow-up is a significant risk factor for early rehospitalization 29,38. Gavish et al38 reported that the lack of a follow-up visit was associated with a significant increased risk of rehospitalization within 90 days of discharge (OR, 2.91; 95% CI, 1.06–8.01).…”

Section: Discussionmentioning

confidence: 99%

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Impact of a COPD comprehensive case management program on hospital length of stay and readmission rates

Alshabanat¹,

Otterstatter²,

Sin³

et al. 2017

COPD

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BackgroundCOPD accounts for the highest rate of hospital admissions among major chronic diseases. COPD hospitalizations are associated with impaired quality of life, high health care utilization, and poor prognosis and result in an economic and a social burden that is both substantial and increasing.AimThe aim of this study is to determine the efficacy of a comprehensive case management program (CCMP) in reducing length of stay (LOS) and risk of hospital admissions and readmissions in patients with COPD.Materials and methodologyWe retrospectively compared outcomes across five large hospitals in Vancouver, BC, Canada, following the implementation of a systems approach to the management of COPD patients who were identified in the hospital and followed up in the community for 90 days. We compared numbers, rates, and intervals of readmission and LOS during 2 years of active program delivery compared to 1 year prior to program implementation.ResultsA total of 1,564 patients with a clinical diagnosis of COPD were identified from 2,719 hospital admissions during the 3 years of study. The disease management program reduced COPD-related hospitalizations by 30% and hospitalizations for all causes by 13.6%. Similarly, the rate of readmission for all causes showed a significant decline, with hazard ratios (HRs) of 0.55 (year 1) and 0.51 (year 2) of intervention (P<0.001). In addition, patients’ mean LOS (days) for COPD-related admissions declined significantly from 10.8 to 6.8 (P<0.05).ConclusionA comprehensive disease management program for COPD patients, including education, case management, and follow-up, was associated with significant reduction in hospital admissions and LOS.

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Section: Discussionmentioning

confidence: 99%

“…On the other hand, lack of follow-up is a significant risk factor for early rehospitalization 29,38. Gavish et al38 reported that the lack of a follow-up visit was associated with a significant increased risk of rehospitalization within 90 days of discharge (OR, 2.91; 95% CI, 1.06–8.01).…”

Section: Discussionmentioning

confidence: 99%

Impact of a COPD comprehensive case management program on hospital length of stay and readmission rates

Alshabanat¹,

Otterstatter²,

Sin³

et al. 2017

COPD

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show abstract

“…Early visits after hospital discharge reduce readmissions in high-risk patients, such as those who were admitted to hospital for chronic obstructive pulmonary disease or heart failure. [9][10][11][12][13] Results have been mixed in other populations. [14][15][16][17][18][19] In 2009, Jencks and colleagues reported that only half of all patients in the Medicare fee-for-service program who had been discharged from hospital had seen a physician before their readmission.…”

mentioning

confidence: 99%

Effectiveness of a financial incentive to physicians for timely follow-up after hospital discharge: a population-based time series analysis

Lapointe‐Shaw

Mamdani

Luo

et al. 2017

CMAJ

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“…Thus, more clinic visits did not appear to mitigate ED visit and hospitalization rates in our sample. Similarly, early clinic follow‐up after hospitalization has been associated with lower risk for hospital readmission among patients with HF and other high‐risk patient groups 32, 33, 34. However, we observed high rates of postdischarge follow‐up within 30 days of hospitalization for HF in all episode types, with highest rates in dual use episodes.…”

Section: Discussionmentioning

confidence: 46%

Dual Healthcare System Use During Episodes of Acute Care Heart Failure Associated With Higher Healthcare Utilization and Mortality Risk

Axon

Gebregziabher

Everett

et al. 2018

JAHA

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BackgroundIndividuals receiving cross‐system care (dual users) have higher rates of healthcare utilization and worse outcomes for heart failure (HF) and other conditions. Individuals can be dual users or single‐system users at different times, though, and little is known about utilization and mortality within discrete episodes of care.Methods and ResultsA retrospective cohort of 3439 patients with 5231 discrete episodes of HF exacerbation were identified between 2007 and 2011. Episodes encompassed the period from 2 weeks before an initial HF emergency department (ED) visit or hospitalization, included any acute care visits within 30 days after initial visit, and ended 30 days after the last acute care visit in the episode chain. All‐cause and HF‐specific ED visits and hospitalization within 30 days of index visit were analyzed using generalized estimating equations with robust variance. Hazard for death within episodes of acute illness was analyzed using Cox proportional hazards models. In adjusted analyses, dual use acute HF episodes were associated with higher odds of all‐cause ED visits (odds ratio 1.61, 95% confidence interval [CI], 1.33, 1.95), HF‐specific ED visits, (odds ratio 1.54, 95% CI, 1.12, 2.13), all‐cause hospitalization (odds ratio 1.89, 95% CI, 1.50, 2.38), and HF‐specific hospitalization (odds ratio 1.62, 95% CI, 1.15–2.30) as compared with Veterans Health Administration–only episodes of acute HF care. Dual use episodes of care were associated with higher hazard for mortality (hazard ratio=1.52, 95% CI 1.07, 2.16) as compared with all–Veterans Health Administration episodes of care.ConclusionsEpisodes of acute HF care spanning across healthcare systems appear to be associated with higher risk of subsequent ED visits, hospitalization, and mortality.

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The Association Between Hospital Readmission and Pulmonologist Follow-up Visits in Patients With COPD

Cited by 82 publications

References 11 publications

Impact of a COPD comprehensive case management program on hospital length of stay and readmission rates

Impact of a COPD comprehensive case management program on hospital length of stay and readmission rates

Effectiveness of a financial incentive to physicians for timely follow-up after hospital discharge: a population-based time series analysis

Dual Healthcare System Use During Episodes of Acute Care Heart Failure Associated With Higher Healthcare Utilization and Mortality Risk

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