Abstract
Prevention of chronic obstructive pulmonary disease hospital readmissions is an international priority aimed to slow disease progression and limit costs. Evidence of the risk of readmission and of interventions that might prevent it is lacking. We aimed to determine readmission risk for chronic obstructive pulmonary disease, factors influencing that risk, and variation in readmission risk between hospitals across 7.5 million people in London. This retrospective longitudinal observational study included all chronic obstructive pulmonary disease admissions to any hospital in the United Kingdom among patients registered at London general practices who had emergency National Health Service chronic obstructive pulmonary disease hospital admissions between April 2006 and March 2010. Influence of patient characteristics, geographical deprivation score, length of stay, day of week of admission or of discharge, and admitting hospital, were assessed using multiple logistic regression. 38,894 chronic obstructive pulmonary disease admissions of 20,932 patients aged ≥ 45 years registered with London general practices were recorded. 6295 patients (32.2%) had at least one chronic obstructive pulmonary disease readmission within 1 year. 1993 patients (10.2%) were readmitted within 30 days and 3471 patients (17.8%) were readmitted within 90 days. Age and patient geographical deprivation score were very weak predictors of readmission. Rates of chronic obstructive pulmonary disease readmissions within 30 days and within 90 days did not vary among the majority of hospitals. The finding of lower chronic obstructive pulmonary disease readmission rates than was previously estimated and the limited variation in these rates between hospitals suggests that the opportunity to reduce chronic obstructive pulmonary disease readmission risk is small.
Highlights
Chronic obstructive pulmonary disease (COPD) is a leading cause of emergency hospital medical admissions and readmissions worldwide.[1, 2] Preventing COPD readmissions following an exacerbation has been identified as an international priority to limit the physical deterioration of patients and to contain costs.[3, 4]In an effort to curb hospital readmissions health service payments to United Kingdom (UK) National Health Service (NHS) hospitals for patients readmitted within 30 days of discharge have been restricted since 2011 under the Payment by Results scheme.[5, 6]This is especially the case for those readmissions judged to be avoidable
This study aimed to describe the readmission risk of COPD hospital admission of all patients registered at all London general practices between 2006 and 2010
This study has provided new insights into the distribution of readmissions among patients admitted to NHS hospitals with COPD exacerbations
Summary
In an effort to curb hospital readmissions health service payments to United Kingdom (UK) National Health Service (NHS) hospitals for patients readmitted within 30 days of discharge have been restricted since 2011 under the Payment by Results scheme.[5, 6]. This is especially the case for those readmissions judged to be avoidable. Smoking is a known risk factor for the development of COPD and is a predictor of COPD exacerbations.[13, 14]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
