David M. Jacobs|Katia Noyes|Jiwei Zhao|Walter T. Gibson|Timothy F. Murphy|Sanjay Sethi|Heather M. Ochs?Balcom
Early Hospital Readmissions after an Acute Exacerbation of Chronic Obstructive Pulmonary Disease in the Nationwide Readmissions Database
Faculty of Public Health|Faculty of Public Health|University at Buffalo, State University of New York|University at Buffalo, State University of New York|Faculty of Public Health
understanding causes factors related readmission acute exacerbation chronic obstructive pulmonary disease aecopd within nationwide database including payers ages provide valuable input development generalizable readmission reduction strategiesto determine rates causes predictors early 3 7 30d readmission patients hospitalized aecopd united states using nationwide readmission database initiation hospital readmissions reduction program expansion copdwe conducted analysis nationwide readmission database 2013 2014 index admissions readmissions aecopd defined consistent hospital readmissions reduction program guidelines investigated percentage 30day readmissions occurring day discharge common readmission diagnoses different time periods hospitalization relationship predictors categorized patient clinical hospital factors early readmission evaluated using hierarchical twolevel logistic model examine covariate effects earlyday readmission predictors 3 7 30day readmissions modeled separatelythere 202300 30day readmissions 1055830 index aecopd admissions rate 192 highest readmission rates 4255 within first 72 hours discharge 58 readmissions within first 15 days respiratorybased diseases common reasons readmission 524 copd common diagnosis 284 readmission diagnoses similar different time periods discharge early readmission associated patient medicaid payer status lower household income higher comorbidity burden clinical factors longer length stay discharge skilled nursing facility predictors vary substantially time readmission discharge within 30day windowthirtyday readmissions aecopd remain major healthcare burden characterized similar spectrum readmission diagnoses predictors associated readmission include patient clinical factors development copdspecific risk stratification algorithm based factors may necessary better predict patients aecopd high risk early readmission