National Healthcare Quality and Disparities Report
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- Adverse Events (2)
- Asthma (2)
- Behavioral Health (1)
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- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- COVID-19 (1)
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- Quality Measures (1)
- Quality of Care (3)
- Racial and Ethnic Minorities (1)
- (-) Respiratory Conditions (23)
- Risk (1)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 23 of 23 Research Studies DisplayedLopez K, Li H, Lipkin-Moore Z
Deep learning prediction of hospital readmissions for asthma and COPD.
The purpose of this observational study was to identify Electronic Health Record (EHR) features of severe asthma and COPD exacerbations and assess the performance of four machine learning (ML) and one deep learning (DL) model in predicting readmissions using EHR data. The study included 31, 2017 patients hospitalized with asthma and COPD exacerbations. The study found that Black and Hispanic patients had a greater likelihood of readmission for asthma. Patients with COPD readmissions included a high percentage of Blacks and Hispanics. To identify patients at high risk of readmission, index hospitalization data of a subset of 2,682 patients, 777 with asthma and 1,905 with COPD, was analyzed with four ML models, and one DL model. The researchers discovered that multilayer perceptron, the DL method, had the best sensitivity and specificity compared to the four ML methods implemented in the same dataset.
AHRQ-funded; HS027626.
Citation: Lopez K, Li H, Lipkin-Moore Z .
Deep learning prediction of hospital readmissions for asthma and COPD.
Respir Res 2023 Dec 13; 24(1):311. doi: 10.1186/s12931-023-02628-7..
Keywords: Asthma, Respiratory Conditions, Hospital Readmissions, Electronic Health Records (EHRs), Health Information Technology (HIT)
Difazio RL, Shore BJ, Melvin P
Pneumonia after hip surgery in children with neurological complex chronic conditions.
The purpose of this retrospective cohort study was to estimate rates of postoperative pneumonia in children with neurological complex chronic conditions (CCC) undergoing hip surgery, to determine the effect of pneumonia on postoperative hospital resource use, and to identify predictors. Researchers used data from the Pediatric Health Information System for children 4 years and older with a neurological CCC who had undergone hip surgery from 2016 to 2018 in U.S. children's hospitals. Findings indicate that postoperative pneumonia in children with a neurological CCC was associated with longer length-of-stay, readmissions, and higher costs. Children who had undergone pelvic osteotomies and who had multimorbidity needed additional clinical support to prevent postoperative pneumonia and to decrease resource utilization.
AHRQ-funded; HS024453.
Citation: Difazio RL, Shore BJ, Melvin P .
Pneumonia after hip surgery in children with neurological complex chronic conditions.
Dev Med Child Neurol 2023 Feb; 65(2):232-42. doi: 10.1111/dmcn.15339..
Keywords: Children/Adolescents, Surgery, Neurological Disorders, Pneumonia, Respiratory Conditions, Hospital Readmissions, Adverse Events
Rojas JC, Chokkara S, Zhu M
Care quality for patients with chronic obstructive pulmonary disease in the readmission penalty era.
The purpose of this study was to assess changes in the quality of care for patients hospitalized for Chronic obstructive pulmonary disease (COPD) after the implementation of the Hospital Readmissions Reduction Program (HRRP) which levied financial penalties on hospitals for excessive COPD readmissions. The researchers reviewed the records from 995 U.S. hospitals in the Premier Healthcare Database, evaluating patients older than 40 years of age hospitalized for COPD. The study included 662,842 pre-HRRP (January 2010-September 2014) and 285,508 post-HRRP (October 2014-December 2018) admissions, and found that recommended care increased at a rate of 0.16% per month pre-HRRP and 0.01% per month post-HRRP. Nonrecommended care decreased at a rate of 0.15% per month pre-HRRP and 0.13% per month post-HRRP. Ideal care increased at a rate of 0.24% per month pre-HRRP and 0.11% per month post-HRRP. The researchers concluded that after HRRP implementation, the pre-HRRP trends toward improving care quality for inpatient COPD care slowed.
AHRQ-funded; HS027804.
Citation: Rojas JC, Chokkara S, Zhu M .
Care quality for patients with chronic obstructive pulmonary disease in the readmission penalty era.
Am J Respir Crit Care Med 2023 Jan; 207(1):29-37. doi: 10.1164/rccm.202203-0496OC..
Keywords: Respiratory Conditions, Quality of Care, Hospital Readmissions, Chronic Conditions
Saxena FE, Bierman AS, Glazier RH
AHRQ Author: Bierman AS
Association of Early Physician Follow-up With Readmission Among Patients Hospitalized for Acute Myocardial Infarction, Congestive Heart Failure, or Chronic Obstructive Pulmonary Disease.
Investigators assessed whether hospitalized patients with early physician follow-up after discharge had lower rates of overall and condition-specific readmissions within 30 days and 90 days of discharge. Studying adults in Ontario, Canada, with first admission for acute myocardial infarction, congestive heart failure, or chronic obstructive pulmonary disease, the findings suggested that early follow-up in conjunction with a comprehensive transitional care strategy for hospitalized patients with medically complex conditions coupled with ongoing effective chronic disease management may be associated with reduced 90-day readmissions.
AHRQ-authored.
Citation: Saxena FE, Bierman AS, Glazier RH .
Association of Early Physician Follow-up With Readmission Among Patients Hospitalized for Acute Myocardial Infarction, Congestive Heart Failure, or Chronic Obstructive Pulmonary Disease.
JAMA Netw Open 2022 Jul;5(7):e2222056. doi: 10.1001/jamanetworkopen.2022.22056..
Keywords: Hospital Readmissions, Hospitalization, Cardiovascular Conditions, Respiratory Conditions, Transitions of Care
Wang Y, Eldridge N, Metersky ML
AHRQ Author: Eldridge N, Rodrick D
Analysis of hospital-level readmission rates and variation in adverse events among patients with pneumonia in the United States.
The purpose of this AHRQ-authored cross-sectional study was to assess whether patients with pneumonia who were admitted to hospitals with higher risk-standardized readmission rates had a higher risk of in-hospital adverse events. The researchers linked patient-level adverse events data from the Medicare Patient Safety Monitoring System (MPSMS) to the hospital-level pneumonia-specific all-cause readmissions data from the Centers for Medicare & Medicaid Services. The MPSMS data included 46,047 patients with pneumonia across 2,590 hospitals discharged from July 1, 2010, through December 31, 2019. For data from 2010 to 2017, analysis was completed from October 2019 through July 2020, and for data from 2018 to 2019 analysis was completed from March through April 2022. The study concluded that readmission rates are associated with the quality of hospital care for pneumonia; patients with pneumonia admitted to hospitals with high all-cause readmission rates had a higher likelihood of developing adverse events during the initial hospitalization.
AHRQ-authored; AHRQ-funded; 290201800005C.
Citation: Wang Y, Eldridge N, Metersky ML .
Analysis of hospital-level readmission rates and variation in adverse events among patients with pneumonia in the United States.
JAMA Netw Open 2022 May 2;5(5):e2214586. doi: 10.1001/jamanetworkopen.2022.14586..
Keywords: Hospital Readmissions, Hospitals, Adverse Events, Pneumonia, Respiratory Conditions
Hirayama A, Goto T, Faridi MK
Association of obstructive sleep apnea with all-cause readmissions after hospitalization for asthma exacerbation in adults aged 18-54 years: a population-based study, 2010-2013.
The authors sought to investigate associations between obstructive sleep apnea (OSA) and readmission risk after hospitalization for asthma exacerbation using data from State Inpatient Databases from seven U.S. states. They found that, overall, OSA was associated with a significantly higher incident rate of all-cause readmission. Additionally, OSA was associated with higher incident rates of readmissions for five major diseases: asthma, COPD, respiratory failure, pneumonia, and congestive heart failure, compared to non-OSA.
AHRQ-funded; HS023305.
Citation: Hirayama A, Goto T, Faridi MK .
Association of obstructive sleep apnea with all-cause readmissions after hospitalization for asthma exacerbation in adults aged 18-54 years: a population-based study, 2010-2013.
J Asthma 2021 Sep;58(9):1176-85. doi: 10.1080/02770903.2020.1781887..
Keywords: Healthcare Cost and Utilization Project (HCUP), Sleep Problems, Hospital Readmissions, Asthma, Respiratory Conditions, Chronic Conditions
Puebla Neira DA, Hsu ES, Kuo YF
Readmissions reduction program: mortality and readmissions for chronic obstructive pulmonary disease.
Implementation of the Hospital Readmissions Reduction Program (HRRP) following discharge of patients with chronic obstructive pulmonary disease (COPD) has led to a reduction in 30-day readmissions with unknown effects on postdischarge mortality. The objective of this retrospective cohort study was to examine the association of HRRP with 30-day hospital readmission and 30-day postdischarge mortality rate in patients after discharge from COPD hospitalization.
AHRQ-funded; HS020642.
Citation: Puebla Neira DA, Hsu ES, Kuo YF .
Readmissions reduction program: mortality and readmissions for chronic obstructive pulmonary disease.
Am J Respir Crit Care Med 2021 Feb 15;203(4):437-46. doi: 10.1164/rccm.202002-0310OC..
Keywords: Hospital Readmissions, Respiratory Conditions, Chronic Conditions, Mortality, Hospital Discharge, Hospitalization
Donnelly JP, Wang XQ, Iwashyna TJ
Readmission and death after initial hospital discharge among patients with COVID-19 in a large multihospital system.
This study describes reasons for readmission, use of intensive care unit (ICU) interventions during readmission, and proportions of death after initial hospital discharge of COVID-19 patients from US Veterans Affairs (VA) hospitals March-June 2020.
AHRQ-funded; HS026725.
Citation: Donnelly JP, Wang XQ, Iwashyna TJ .
Readmission and death after initial hospital discharge among patients with COVID-19 in a large multihospital system.
JAMA 2021 Jan 19;325(3):304-06. doi: 10.1001/jama.2020.21465.
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Keywords: Respiratory Conditions, COVID-19, Hospital Readmissions, Hospital Discharge, Mortality, Outcomes
Steuart R, Tan R, Melink K
Discharge before return to respiratory baseline in children with neurologic impairment.
Children with neurologic impairment (NI) are commonly hospitalized with acute respiratory infections (ARI). These children frequently require respiratory support at baseline and are often discharged before return to respiratory baseline. The purpose of this study was to determine if discharge before return to respiratory baseline was associated with reutilization among children with NI hospitalized with ARI.
AHRQ-funded; HS025138.
Citation: Steuart R, Tan R, Melink K .
Discharge before return to respiratory baseline in children with neurologic impairment.
J Hosp Med 2020 Sep;15(9):531-37. doi: 10.12788/jhm.3394..
Keywords: Children/Adolescents, Neurological Disorders, Respiratory Conditions, Hospital Readmissions, Hospital Discharge, Hospitals
Goto T, Yoshida K, Faridi MK
Contribution of social factors to readmissions within 30 days after hospitalization for COPD exacerbation.
This study examined whether adding social factors improved the predictive ability for 30-day hospital readmissions for COPD. Social factors include educational level and marital status. Out of 905 hospitalizations identified in the Medicare Current Beneficiary Survey from 2006 through 2012, 18.5% were readmitted within 30 days. The optimized model including social factors for prediction improved for early readmissions but not for late readmissions.
AHRQ-funded; HS023305.
Citation: Goto T, Yoshida K, Faridi MK .
Contribution of social factors to readmissions within 30 days after hospitalization for COPD exacerbation.
BMC Pulm Med 2020 Apr 29;20(1):107. doi: 10.1186/s12890-020-1136-8..
Keywords: Respiratory Conditions, Hospital Readmissions, Hospitalization, Social Determinants of Health, Chronic Conditions
Hirayama A, Goto T, Hasegawa K
Association of acute kidney injury with readmissions after hospitalization for acute exacerbation of chronic obstructive pulmonary disease: a population-based study.
This study examined the association between acute kidney injury (AKI) and readmission with hospitalization for acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Retrospective, population-based cohort data was used from the HCUP State Inpatient Databases from seven states (Arkansas, California, Florida, Iowa, Nebraska, New York, and Utah) from 2010 through 2013. A total of 356,990 patients were identified as hospitalized for AECOPD. Median age was 71 years and 41.9% were male. Of those 7% had a concurrent diagnosis of AKI. Patients with AKI were found to have a significantly higher risk of 30-day all-cause readmission compared to those without AKI as well as a significantly higher risk of 90-day all-cause readmission, particularly for non-respiratory reasons. These reasons included sepsis, acute renal failure, and congestive heart failure.
AHRQ-funded; HS023305.
Citation: Hirayama A, Goto T, Hasegawa K .
Association of acute kidney injury with readmissions after hospitalization for acute exacerbation of chronic obstructive pulmonary disease: a population-based study.
BMC Nephrol 2020 Apr 3;21(1):116. doi: 10.1186/s12882-020-01780-2..
Keywords: Healthcare Cost and Utilization Project (HCUP), Respiratory Conditions, Chronic Conditions, Hospital Readmissions, Hospitalization, Kidney Disease and Health
Myers LC, Faridi MK, Hasegawa K
The hospital readmissions reduction program and readmissions for chronic obstructive pulmonary disease, 2006-2015.
In October 2012, the initial phase of the Hospital Readmission Reduction Program imposed financial penalties on hospitals with higher-than-expected risk-adjusted 30-day readmission rates for Medicare beneficiaries with congestive heart failure, myocardial infarction, and pneumonia. In this study, the investigators hypothesized that these penalties may also be associated with decreased readmissions for chronic obstructive pulmonary disease (COPD) in the general population before COPD became a target condition (October 2014).
AHRQ-funded; HS023305.
Citation: Myers LC, Faridi MK, Hasegawa K .
The hospital readmissions reduction program and readmissions for chronic obstructive pulmonary disease, 2006-2015.
Ann Am Thorac Soc 2020 Apr;17(4):450-56. doi: 10.1513/AnnalsATS.201909-672OC..
Keywords: Respiratory Conditions, Hospital Readmissions, Hospitals, Chronic Conditions, Medicare
Kaiser SV, Lam R, Joseph GB
Limitations of using pediatric respiratory illness readmissions to compare hospital performance.
Researcher sought to determine if a National Quality Forum (NQF)-endorsed measure for pediatric lower respiratory illness (LRI) 30-day readmission rates can meaningfully identify high- and low-performing hospitals. Subjects were children with LRI (bronchiolitis, influenza, or pneumonia as primary diagnosis, or with an LRI as a secondary diagnosis with a primary diagnosis of respiratory failure, sepsis, bacteremia, or asthma) from all hospital admissions in California from 2012 to 2014. The researchers were unable to identify meaningful variation in hospital performance without broadening the metric definition and merging multiple years of data. They recommend that utilizers of pediatric-quality measures consider modifying metrics to better evaluate the quality of pediatric care at low-volume hospitals.
AHRQ-funded; HS024385; HS022835; HS024592; HS025297.
Citation: Kaiser SV, Lam R, Joseph GB .
Limitations of using pediatric respiratory illness readmissions to compare hospital performance.
J Hosp Med 2018 Nov;13(11):737-42. doi: 10.12788/jhm.2988..
Keywords: Children/Adolescents, Respiratory Conditions, Provider Performance, Hospital Readmissions, Hospitals, Quality Indicators (QIs), Quality Measures, Quality of Care, Quality Improvement
Mittal M, Wang CE, Goben AH
Proprietary management and higher readmission rates: a correlation.
This study examined readmission rates of patients for six diseases including acute myocardial infarction, heart failure, coronary artery bypass graft, pneumonia, COPD, and total hip or total knee arthroplasty from the Center for Medicare and Medicaid Readmissions Reduction Production (HRRP) for 2012 to 2015. The type of hospital ownership was the variable that was being studied. There were statistically higher readmission rates in proprietary (for profit) hospitals compared to government and non-profit hospitals. This was true regardless of their location.
AHRQ-funded; HS024679.
Citation: Mittal M, Wang CE, Goben AH .
Proprietary management and higher readmission rates: a correlation.
PLoS One 2018 Sep 18;13(9):e0204272. doi: 10.1371/journal.pone.0204272..
Keywords: Cardiovascular Conditions, Hospital Readmissions, Hospitals, Orthopedics, Respiratory Conditions
Goto T, Faridi MK, Camargo CA
Time-varying readmission diagnoses during 30 days after hospitalization for COPD exacerbation.
The purpose of this study was to investigate the longitudinal changes in principal readmission diagnoses within 30 days after hospitalization for acute exacerbation of chronic obstructive pulmonary disease (AECOPD). The investigators found that the proportions of principal discharge diagnosis of readmission changed significantly at around postdischarge day 7.
AHRQ-funded; HS023305.
Citation: Goto T, Faridi MK, Camargo CA .
Time-varying readmission diagnoses during 30 days after hospitalization for COPD exacerbation.
Med Care 2018 Aug;56(8):673-78. doi: 10.1097/mlr.0000000000000940..
Keywords: Respiratory Conditions, Hospital Readmissions, Hospitalization
Goto T, Faridi MK, Gibo K
Sex and racial/ethnic differences in the reason for 30-day readmission after COPD hospitalization.
This retrospective cohort study used 2006-2012 data from the State Inpatient Database of eight geographically-diverse US states (Arkansas, California, Florida, Iowa, Nebraska, New York, Utah, and Washington) to examine 30-day readmissions in patients hospitalized for chronic obstructive pulmonary disease (COPD). In their analysis of all-payer population-based data, the authors found sex and racial/ethnic differences in the reason for 30-day readmission in patients hospitalized for COPD.
AHRQ-funded; HS023305.
Citation: Goto T, Faridi MK, Gibo K .
Sex and racial/ethnic differences in the reason for 30-day readmission after COPD hospitalization.
Respir Med 2017 Oct;131:6-10. doi: 10.1016/j.rmed.2017.07.056..
Keywords: Respiratory Conditions, Healthcare Cost and Utilization Project (HCUP), Racial and Ethnic Minorities, Hospital Readmissions, Sex Factors
Goto T, Faridi MK, Gibo K
Trends in 30-day readmission rates after COPD hospitalization, 2006-2012.
This study investigated trends in 30-day readmission rates after chronic obstructive pulmonary disease (COPD)-related hospitalization. Overall, the 30-day readmission rate for COPD-related hospitalization decreased modestly from 20.0 percent in 2006 to 19.2 percent in 2012. Similar to the overall population, the readmission rate over the 7-year period remained persistently high in most of AHRQ-defined priority populations.
AHRQ-funded; HS023305.
Citation: Goto T, Faridi MK, Gibo K .
Trends in 30-day readmission rates after COPD hospitalization, 2006-2012.
Respir Med 2017 Sep;130:92-97. doi: 10.1016/j.rmed.2017.07.058.
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Keywords: Respiratory Conditions, Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Social Determinants of Health, Vulnerable Populations
Rinne ST, Castaneda J, Lindenauer PK
Chronic obstructive pulmonary disease readmissions and other measures of hospital quality.
This study examined the association between COPD readmissions and other quality measures. There were modest correlations between COPD readmission rates and readmission rates for other medical conditions, including heart failure , acute myocardial infarction, pneumonia, and stroke . In contrast, it also found low correlations between COPD readmission rates and readmission rates for surgical conditions, as well as mortality rates for all measured conditions.
AHRQ-funded; HS016978.
Citation: Rinne ST, Castaneda J, Lindenauer PK .
Chronic obstructive pulmonary disease readmissions and other measures of hospital quality.
Am J Respir Crit Care Med 2017 Jul 1;196(1):47-55. doi: 10.1164/rccm.201609-1944OC.
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Keywords: Respiratory Conditions, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Quality of Care, Hospital Readmissions, Hospitals
Bhatt SP, Wells JM, Iyer AS
Results of a Medicare bundled payments for care improvement initiative for chronic obstructive pulmonary disease readmissions.
This study evaluated whether a comprehensive chronic obstructive pulmonary disease (COPD) multidisciplinary intervention focusing on inpatient, transitional, and outpatient care as part of an institution's Bundled Payments for Care Improvement (BPCI) participation would reduce 30-day all-cause readmission rates for COPD exacerbations and reduce overall costs. It concluded that a Medicare BPCI intervention did not reduce 30-day all-cause readmission rates or overall costs after hospitalization for acute exacerbation of COPD.
AHRQ-funded; HS013852.
Citation: Bhatt SP, Wells JM, Iyer AS .
Results of a Medicare bundled payments for care improvement initiative for chronic obstructive pulmonary disease readmissions.
Ann Am Thorac Soc 2017 May;14(5):643-48. doi: 10.1513/AnnalsATS.201610-775BC.
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Keywords: Respiratory Conditions, Payment, Hospital Readmissions, Medicare, Quality Improvement
Hasegawa K, Camargo CA, Jr.
Prevalence of blood eosinophilia in hospitalized patients with acute exacerbation of COPD.
In this first study to investigate the prevalence of eosinophilia among inpatients with acute exacerbation of COPD, the authors found that 17% had blood eosinophilia, and that such patients had higher frequency of readmission during a one-year follow-up period.
AHRQ-funded; HS023305.
Citation: Hasegawa K, Camargo CA, Jr. .
Prevalence of blood eosinophilia in hospitalized patients with acute exacerbation of COPD.
Respirology 2016 May;21(4):761-4. doi: 10.1111/resp.12724.
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Keywords: Respiratory Conditions, Elderly, Hospitalization, Outcomes, Hospital Readmissions
Singh G, Zhang W, Kuo YF
Association of psychological disorders with 30-day readmission rates in patients with COPD.
Using a 5 percent sample of Medicare beneficiaries, the researchers examined the association of psychological disorders such as depression, anxiety, psychosis, alcohol abuse and drug abuse with early readmission for patients with COPD. They found that psychological disorders like depression, anxiety, psychosis, alcohol abuse and drug abuse are independently associated with higher all-cause 30-day readmission rates for Medicare beneficiaries with COPD.
AHRQ-funded; HS020642; HS022134.
Citation: Singh G, Zhang W, Kuo YF .
Association of psychological disorders with 30-day readmission rates in patients with COPD.
Chest 2016 Apr;149(4):905-15. doi: 10.1378/chest.15-0449..
Keywords: Behavioral Health, Hospital Readmissions, Medicare, Respiratory Conditions
Iyer AS, Bhatt SP, Garner JJ
Depression is associated with readmission for acute exacerbation of chronic obstructive pulmonary disease.
The authors characterized the associations between depression and anxiety and COPD readmission risk. They found that depression is an independent risk factor for both short- and long-term readmissions for acute exacerbation of COPD and may represent a modifiable risk factor. They also found that in-hospital tobacco cessation counseling was associated with reduced 1-year readmission.
AHRQ-funded; HS013852.
Citation: Iyer AS, Bhatt SP, Garner JJ .
Depression is associated with readmission for acute exacerbation of chronic obstructive pulmonary disease.
Ann Am Thorac Soc 2016 Feb;13(2):197-203. doi: 10.1513/AnnalsATS.201507-439OC.
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Keywords: Respiratory Conditions, Depression, Hospital Readmissions, Risk, Tobacco Use
Shah T, Churpek MM, Coca Perraillon M
Understanding why patients with COPD get readmitted: a large national study to delineate the Medicare population for the readmissions penalty expansion.
The Hospital Readmissions Reduction Program (HRRP) penalizes hospitals for 30-day readmissions and was extended to COPD in October 2014. The authors investigated readmission risk factors and reasons for readmission in order to guide hospitals in initiating programs to reduce COPD readmissions. They found that patients discharged home without home care were more likely to be readmitted for COPD than patients discharged to post-acute care, and those readmitted were more likely to be dually enrolled in Medicare and Medicaid, have a longer median length of stay, and have more comorbidities. They concluded that the addition of COPD to the readmissions penalty may further worsen the disproportionately high penalties seen in safety net hospitals.
AHRQ-funded; HS021877.
Citation: Shah T, Churpek MM, Coca Perraillon M .
Understanding why patients with COPD get readmitted: a large national study to delineate the Medicare population for the readmissions penalty expansion.
Chest 2015 May;147(5):1219-26. doi: 10.1378/chest.14-2181.
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Keywords: Respiratory Conditions, Elderly, Medicare, Hospital Readmissions