The association between hospital readmission and pulmonologist follow-up visits in patients with COPD

Rachel Gavish, Amalia Levy, Or Kalchiem Dekel, Erez Karp, Nimrod Maimon

Research output: Contribution to journalArticlepeer-review

65 Scopus citations

Abstract

BACKGROUND: The high frequency of readmissions in patients with COPD remains a signifi-cant problem. The impact of a pulmonologist follow-up visit during the month After discharge from hospital because of COPD exacerbation on reducing readmissions was examined. A profi le of patients who did not attend the follow-up visits was built. METHODS: Our population-based retrospective cohort study analyzed the data of all patients with COPD 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, a higher number of hospitalizations in the previous year, a lack of a recommendation in the discharge letter for a follow-up visit, and a lower frequency of follow-up visits with pulmonologists in the previous year. Moreover, not attending the follow-up visit was associated with a significant increased risk of rehospitalization within 90 days of discharge (OR, 2.91; 95% CI, 1.06-8.01). CONCLUSIONS: Early follow-up visits with pulmonologists seem to reduce the exacerbationrelated rehospitalization rates of patients with COPD. We recommend that patients have early postdischarge follow-up visits with pulmonologists.

Original languageEnglish
Pages (from-to)375-381
Number of pages7
JournalChest
Volume148
Issue number2
DOIs
StatePublished - 1 Aug 2015

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

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