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Addressing Hospital Readmissions and Emergency Department Visits for COPD Patients

COPD exacerbations are acute events in which disease symptoms become more severe than usual, including shortness of breath from routine activities and excessive coughing. Patients experiencing exacerbations typically a) visit the emergency department and may be admitted to the hospital and b) are readmitted to the hospital shortly after discharge. Such service utilization is a hallmark challenge of COPD management. Providers often examine rates of emergency department visits and hospital readmissions among their COPD patients to determine how well the condition is controlled, since well-maintained COPD typically does not flare up and require emergency services.

Due to the high cost of emergency department services and hospitalizations and the fact that COPD exacerbations are typically preventable, many programs focus on preventing emergency department visits and hospital (re)admissions. Such programs help patients maintain their COPD through wellness practices and care management to prevent exacerbations. Patients should work with their healthcare providers to create an action plan as a method of self-managing COPD. Action plans may include directions for taking emergency antibiotics and steroids, or "rescue packs" that contain a five-day course that patients can start if they begin to feel an exacerbation and are unable to get to a healthcare provider or hospital in a reasonable amount of time. This is critical for rural patients, who may not be able to easily access a hospital. As such, efforts to reduce emergency department visits and hospitalizations typically take place outside of the inpatient setting.

Resources to Learn More

Insights about the Economic Impact of COPD Readmissions Post Implementation of the Hospital Readmission Reduction Program
Document
A review of the literature published between 2016 and 2017 discussing the direct and indirect financial savings in COPD readmission costs after the implementation of CDC's Hospital Readmissions Reduction Program (HRRP).
Author(s): Press, V, Konetzka, RT, & White, S.
Citation: Current Opinion in Pulmonary Medicine, 24(2), 138–146
Date: 3/2018