Time-varying Readmission Diagnoses During 30 Days After Hospitalization for COPD Exacerbation

Goto, Tadahiro; Faridi, Mohammad Kamal; Camargo, Carlos A.; Hasegawa, Kohei

doi:10.1097/mlr.0000000000000940

Cited by 12 publications

(4 citation statements)

References 20 publications

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“…Go to states the re-admission pattern for COPD related cases was also lower in Hispanic patients compared to non-Hispanic patients. This aligns with our results as we concluded that the disparity of healthcare expenditures is lower in the Hispanic population [26].…”

Section: Resultssupporting

confidence: 93%

Direct Medical Expenditures and Healthcare Utilizations in US Hispanic vs. Non-Hispanic Patients with Chronic Obstructive Pulmonary Disease (COPD): An Analysis of the Medical Expenditure Panel Survey 2012-2016

Chang

2020

BJSTR

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This study aimed to evaluate how chronic obstructive pulmonary disease incidence, healthcare utilization, and cost differ by Hispanic vs. non-Hispanic population category in the United States. Methods:The retrospective database analysis was employed using 2012-2016 Medical Expenditure Panel Survey (MEPS) data for patients with COPD. Study outcomes were COPD incidence, healthcare utilization, and healthcare expenditure among Hispanic vs. non-Hispanic population. All-cause direct medical utilization and expenditures were calculated for the following categories of health care services: inpatient hospitalizations, hospital outpatient visits, emergency room visits, officebased physician visits, home health care visits, and prescription medications.Results: Based on the MEPS data, the total of 11,235 (weighted sample size: 4,869,868) patients were included in the analysis after applying inclusion criteria (Hispanic: 2,218 (weighted sample size: 2,363,375) and Non-Hispanic: 9,017 (weighted sample size: 22,506,493)). Hispanic patients had significantly lower expenditures on inpatients visits, hospital outpatients, medications prescriptions compared to Non-Hispanic patients (p<0.001). The incremental cost (Non-Hispanic minus Hispanic) was $ 1,742.83 (95% CI: 404.35-3,081.32, p=0.011), indicating that Non-Hispanic group had significantly higher cost on overall health care services compared to Hispanic group. Similarly, Non-Hispanic patients showed $ 764.14 (95% CI: 453.40-1,074.89) higher expenditures related COPD than Hispanic patients ($ 1,945.61 (95% CI: 1,674.63-2,216.58) vs. $ 1,181.47 (95% CI: 950.44-1,412.49). Both inpatients visits and medications prescriptions linked to COPD diagnosis events were significantly higher for Non-Hispanic patients than Hispanic patients. Conclusion:The results of our study demonstrate that non-Hispanics with COPD have higher healthcare utilization costs compared to Hispanics with COPD. While the overall amount spent on healthcare by Hispanics is less, it emphasizes the need for better management in this subset of the population to minimize the future harm and to establish a fair healthcare system for all Americans.

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Section: Resultssupporting

confidence: 93%

Direct Medical Expenditures and Healthcare Utilizations in US Hispanic vs. Non-Hispanic Patients with Chronic Obstructive Pulmonary Disease (COPD): An Analysis of the Medical Expenditure Panel Survey 2012-2016

Chang

2020

BJSTR

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“…Because many other studies of AECOPD had used 30 days as a standard of readmission, we did likewise. 10 , 11 Events were divided into two groups, one in which the patient was readmitted within 30 days after discharge and the other with no readmission within 30 days. This study was approved by the Institutional Review Board of the Korea University Guro Hospital (KUGH16131-002).…”

Section: Methodsmentioning

confidence: 99%

<em>Pseudomonas aeruginosa</em> infection increases the readmission rate of COPD patients

Choi

Lee

et al. 2018

COPD

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IntroductionAcute exacerbation of COPD (AECOPD) leads to rapid deterioration of pulmonary function and quality of life. It is unclear whether the prognosis for AECOPD differs depending on the bacterium or virus identified. The purpose of this study is to determine whether readmission of patients with severe AECOPD varies according to the bacterium or virus identified.MethodsWe performed a retrospective review of medical records of 704 severe AECOPD events at Korea University Guro Hospital from January 2011 to May 2017. We divided events into two groups, one in which patients were readmitted within 30 days after discharge and the other in which there was no readmission.ResultsOf the 704 events, 65 were followed by readmission within 30 days. Before propensity score matching, the readmission group showed a higher rate of bacterial identification with no viral identification and a higher rate of identification with the Pseudomonas aeruginosa (P=0.003 and P=0.007, respectively). Using propensity score matching, the readmission group still showed a higher P. aeruginosa identification rate (P=0.030), but there was no significant difference in the rate of bacterial identification, with no viral identification (P=0.210). In multivariate analysis, the readmission group showed a higher P. aeruginosa identification rate than the no-readmission group (odds ratio, 4.749; 95% confidence interval, 1.296–17.041; P=0.019).ConclusionP. aeruginosa identification is associated with a higher readmission rate in AECOPD patients.

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“…With the growth of age, the immune system is weakened, cough re ex is weakened, the coexistence of multiple diseases and malnutrition, these factors make the elderly become the high-risk group of infection, and bacterial and viral infection is considered to be the most common cause of acute exacerbation of COPD patients [16] . Foreign studies have shown that the 30-day readmission rate of COPD patients is 6.70%-7.54%, and the readmission rate of elderly patients is as high as 18.4% [3][4][5] .…”

Section: Discussionmentioning

confidence: 99%

“…According to the Global Initiative on Chronic Obstructive Pulmonary Disease (2019) : Chronic Obstructive Pulmonary Disease (COPD) is one of the diseases with the highest morbidity and mortality worldwide, and has become a major challenge to public health [1] , while acute exacerbation of COPD is an important event in the process of Disease management [2] . Studies have shown that the readmission rate of acute exacerbation in COPD patients within 30 days is 6.70%-7.54%, among which the readmission rate of elderly patients is 18.4%, and age is an independent in uencing factor [3][4][5] . Due to the short acute exacerbation cycle of COPD within 30 days, readmission not only seriously damages lung function and increases the risk of death, but also occupies a large number of medical resources, which has been taken as one of the evaluation indicators of hospital medical quality in the United States [6] .…”

Section: Introductionmentioning

confidence: 99%

A Structural Equation Model-Based Study on The Status and Influencing Factors of Acute Exacerbation Readmission in Elderly Patients with Chronic Obstructive Pulmonary Disease within 30 Days

Zhang

Chang

et al. 2022

Preprint

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Objective To investigate the situation of acute exacerbation readmission in elderly patients with Chronic Obstructive Pulmonary Disease (COPD) within 30 days, and to explore the influencing factors of readmission by structural equation model, so as to provide evidence for medical staff to take effective intervention measures. Methods Convenience sampling method was used to select 1120 elderly COPD patients from respiratory department of 13 general hospitals in Ningxia region from April 2019 to August 2020 for questionnaire survey. The participants completed the questionnaire containing general data questionnaire, Modified Medical Research Council (mMRC), Activities of Daily Living (ADL), the Geriatric Depression Scale (GDS), and COPD Assessment Test (CAT) scale. Results The readmission rate of acute exacerbation within 30 days in elderly COPD patients was 21.52%; The modified model fits well. Fitting results showed that seasonal factors, family rehabilitation, age factors and overall status were the direct influencing factors of acute exacerbation readmission in elderly COPD patients within 30 days. Smoking status is not only a direct factor for acute exacerbation of readmission within 30 days, but also an indirect effect through disease status; Disease status and chronic disease are not only direct factors for acute exacerbation of readmission within 30 days, but also indirectly through overall status. Conclusions The rate of acute exacerbation readmission within 30 days in elderly patients with COPD is high, While taking measures to prevent readmission based on direct influencing factors, attention should be paid to the interaction between factors.

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Time-varying Readmission Diagnoses During 30 Days After Hospitalization for COPD Exacerbation

Abstract: The proportions of principal discharge diagnosis of readmission changed significantly at around postdischarge day 7. Our findings advance research into identification of the underlying mechanisms and development of targeted interventions to prevent readmissions.

Cited by 12 publications

References 20 publications

Direct Medical Expenditures and Healthcare Utilizations in US Hispanic vs. Non-Hispanic Patients with Chronic Obstructive Pulmonary Disease (COPD): An Analysis of the Medical Expenditure Panel Survey 2012-2016

Direct Medical Expenditures and Healthcare Utilizations in US Hispanic vs. Non-Hispanic Patients with Chronic Obstructive Pulmonary Disease (COPD): An Analysis of the Medical Expenditure Panel Survey 2012-2016

<em>Pseudomonas aeruginosa</em> infection increases the readmission rate of COPD patients

A Structural Equation Model-Based Study on The Status and Influencing Factors of Acute Exacerbation Readmission in Elderly Patients with Chronic Obstructive Pulmonary Disease within 30 Days

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