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The association between hospital readmission and pulmonologist follow-up visits in patients with Chronic Obstructive Pulmonary Disease.
Chest. 2015 Jan 22;
Authors: Gavish R, Levy A, Dekel OK, Karp E, Maimon N
Abstract
Background: The high frequency of readmissions in patients with chronic obstructive pulmonary disease (COPD) remains a significant problem. The impact of a pulmonologist follow-up visit during the month after discharge from hospital due to COPD exacerbation on reducing readmissions was examined. A profile of patients who did not attend the follow-up visits was built.
Methods: Our population-based retrospective cohort study analyzed the data of all COPD patients who were treated at a lung institute in an Israeli hospital and were hospitalized between January 1, 2004, and December 31, 2010. Multivariate logistic regression was used to characterize the patient who did not attend the follow up visit and to examine the effect of lack of visit on rehospitalization within 90 days of discharge. Cox proportional hazards analysis was used to model the effect of lacking visit on additional hospitalization or death during the study period.
Results: Of the 195 patients enrolled in the study, 44.1% had follow-up visits with pulmonologists within 30 days of discharge. Not attending the follow-up visit was associated with distant residence, higher number of hospitalizations in the previous year, lack of a recommendation in the discharge letter for a follow-up visit, and lower frequency of follow-up visits with pulmonologists in the previous year. Moreover, not attending the follow-up visit were associated with a significant increased risk for rehospitalization within 90 days from discharge (odd ratio [OR], 2.91; 95% confidence interval [CI], 1.06-8.01).
Conclusions: Early follow-up visits with pulmonologists seem to reduce exacerbation related rehospitalization rates of COPD patients. We recommend that patients have early post-discharge follow-up visits with pulmonologists.
PMID: 25611698 [PubMed - as supplied by publisher]