Closeup image of older adult patient in bed being checked by doctor with stethoscope; Credit: Getty Images

Hospital readmissions are common and costly among patients transitioning from hospital to home after treatment for chronic obstructive pulmonary disease exacerbation. But a post-acute, in-home management program can significantly reduce 30-, 60- and 90-day rates of return, investigators say.

In a new study, researchers followed nearly 1,100 patients discharged from stays with the Atlantic Health System. The study group received an evidence-based home COPD Disease Management Program administered by a respiratory therapist with a patient- and family-centered approach.

About 12% of patients who received the at-home disease management program were readmitted to the hospital for exacerbation within 30 days of discharge. In comparison, approximately 22% who did not receive the intervention were readmitted within that time period. Significant differences favoring the therapy program were also found for 60- and 90-day readmission, reported Rupal Mansukhani, of Rutgers University in New Jersey.

COPD burden

COPD is the third most common cause of Medicare beneficiary readmissions, according to Mansukhani and colleagues. Fully 60% of patients return to the hospital within one year of discharge and 30% return within 3 months of discharge. What’s more, COPD exacerbations leading to hospitalization account for $13.2 billion of nearly $50 billion annual direct costs for COPD, they reported.

The Centers for Medicare & Medicaid Services in 2015 set limits on payments to hospitals with high readmission rates for COPD patients readmitted with exacerbation. 

The study team included representatives from At Home Medical, which provided the respiratory therapy services.

The study was published in the journal Respiratory Care.

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