Reducing COPD Readmissions Strategies for the Pulmonologist to Improve Outcomes

被引:17
作者
Freedman, Neil [1 ]
机构
[1] Northshore Univ Hlth Syst, Dept Med, Div Pulm Crit Care Allergy & Immunol, 2650 Ridge Ave, Evanston, IL 60201 USA
关键词
acute exacerbation of COPD; advanced practice practitioner; Centers for Medicare & Medicaid Services; Global Initiative for Chronic Obstructive Lung Disease; OBSTRUCTIVE PULMONARY-DISEASE; POSITIVE-PRESSURE VENTILATION; FOLLOW-UP VISITS; HOSPITAL DISCHARGE; MANAGEMENT PROGRAM; PHYSICAL-ACTIVITY; IMPACT; EXACERBATIONS; FAILURE; RATES;
D O I
10.1016/j.chest.2019.06.005
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Hospitalizations for patients with acute exacerbations of COPD are associated with several adverse patient outcomes as well as with significant health-care costs. Despite many interventions targeted at reducing readmissions following an initial hospitalization, there are few strategies that have been consistently associated with reductions in this outcome. Despite the lack of consensus as to the best strategies to deploy to reduce readmissions related to acute exacerbations of COPD, efforts must continue to focus on determining the best approaches for this population. These tactics will need to be cost-effective for payers while not being cost-prohibitive for providers. In addition, these interventions will need to be relatively easy to institute while not being overbearing for patients or providers. Larger systems with their greater financial resources will likely find success with technology and data-driven comprehensive programs; independent hospitals and practices are more likely to succeed with less resource-intensive interventions such as early postdischarge follow-up, coaching, action plans, self-management education, and pulmonary rehabilitation. Choosing the right interventions that will utilize financial and human resources in a cost-effective manner, while tailoring the approaches to meet the needs of a specific patient group, will be of key importance.
引用
收藏
页码:802 / 807
页数:6
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