The Impact of a Home Respiratory Therapist to Reduce 30-Day Readmission Rates for Exacerbation of COPD.

COPD Centers for Medicare and Medicaid Services adherence home care agency home care program home visit program hospital readmission patient centered care patient education respiratory therapy

Journal

Respiratory care
ISSN: 1943-3654
Titre abrégé: Respir Care
Pays: United States
ID NLM: 7510357

Informations de publication

Date de publication:
06 2022
Historique:
pubmed: 7 1 2022
medline: 26 5 2022
entrez: 6 1 2022
Statut: ppublish

Résumé

In 2015, the Centers for Medicare and Medicaid Services limited payments to hospitals with high readmission rates for patients admitted with COPD exacerbation. Decreasing readmissions in this patient population improves patient health and decreases health care utilization of resources. We hypothesized a COPD disease management program delivered by a respiratory therapist (RT) in the patient's home may reduce readmission rates for COPD exacerbation. We performed a pre/post interventional study comparing hospital readmissions for subjects with COPD exacerbation that received standard of care in the home versus an RT-led home COPD disease management program. Subjects discharged home from Atlantic Health System with COPD exacerbation were enrolled in the pre-intervention group. Subsequently, an evidence-based home COPD disease management program was implemented by an RT from At Home Medical in the home. The home COPD Disease Management Program was implemented from April 2017-September 2019, and this served as the post-intervention group. The primary end point was readmission rates at 30 d. Secondary end points included 60-d and 90-d readmission rates. A total of 1,093 participants were included in the study, 658 in the pre-intervention cohort and 435 participants in the post-intervention group. Approximately 22.3% ( The COPD Disease Management Program is significantly associated with decreased readmission adjusting for demographics and smoking status.

Sections du résumé

BACKGROUND
In 2015, the Centers for Medicare and Medicaid Services limited payments to hospitals with high readmission rates for patients admitted with COPD exacerbation. Decreasing readmissions in this patient population improves patient health and decreases health care utilization of resources. We hypothesized a COPD disease management program delivered by a respiratory therapist (RT) in the patient's home may reduce readmission rates for COPD exacerbation.
METHODS
We performed a pre/post interventional study comparing hospital readmissions for subjects with COPD exacerbation that received standard of care in the home versus an RT-led home COPD disease management program. Subjects discharged home from Atlantic Health System with COPD exacerbation were enrolled in the pre-intervention group. Subsequently, an evidence-based home COPD disease management program was implemented by an RT from At Home Medical in the home. The home COPD Disease Management Program was implemented from April 2017-September 2019, and this served as the post-intervention group. The primary end point was readmission rates at 30 d. Secondary end points included 60-d and 90-d readmission rates.
RESULTS
A total of 1,093 participants were included in the study, 658 in the pre-intervention cohort and 435 participants in the post-intervention group. Approximately 22.3% (
CONCLUSIONS
The COPD Disease Management Program is significantly associated with decreased readmission adjusting for demographics and smoking status.

Identifiants

pubmed: 34987079
pii: respcare.08125
doi: 10.4187/respcare.08125
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

631-637

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2022 by Daedalus Enterprises.

Déclaration de conflit d'intérêts

The authors have disclosed no conflicts of interest.

Auteurs

Monica Truumees (M)

Atlantic Health System/At Home Medical, Morris Plains, New Jersey.

Moira Kendra (M)

Atlantic Health System, Morristown, New Jersey.

Danielle Tonzola (D)

Morristown Medical Center, Morristown, New Jersey.

Stephanie Chiu (S)

Atlantic Health Center of Research, Morristown, New Jersey.

Federico Cerrone (F)

Atlantic Medical Group/Pulmonary and Allergy Associates, Summit, New Jersey.

Debra Zimmerman (D)

Newton Medical Center, Newton, New Jersey.

Cristen Mackwell (C)

Hackettstown Medical Center, Hackettstown, New Jersey.

Catherine Stevens (C)

Chilton Medical Center, Pompton Plains, New Jersey.

Katelyn Scannell (K)

Overlook Medical Center, Summit, New Jersey.

Brittney Daley (B)

Morristown Medical Center, Morristown, New Jersey.

Daniel Markley (D)

Atlantic Medical Group/Pulmonary and Allergy Associates, Cedar Knolls, New Jersey.

Chirag V Shah (CV)

Atlantic Medical Group/Pulmonary and Allergy Associates, Cedar Knolls, New Jersey.

Rupal Mansukhani (R)

Morristown Medical Center, Morristown, New Jersey; and Rutgers University, Piscataway, New Jersey. Rupal.mansukhani@atlantichealth.org.

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