4.1 Review

Insights about the economic impact of chronic obstructive pulmonary disease readmissions post implementation of the hospital readmission reduction program

Journal

CURRENT OPINION IN PULMONARY MEDICINE
Volume 24, Issue 2, Pages 138-146

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MCP.0000000000000454

Keywords

chronic obstructive pulmonary disease readmissions; healthcare economics; readmission costs; readmission penalty; value-based care

Funding

  1. NHLBI NIH HHS [L30 HL097698] Funding Source: Medline

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Purpose of review Chronic obstructive pulmonary disease (COPD) affects over 12 million adults in the United States and is the third leading cause of 30-day readmissions. COPD is costly with almost $50 billion in direct costs annually. Total COPD costs can be up to double the identified direct costs because of comorbid disease and numerous indirect costs such as absenteeism. Acute exacerbations of COPD (AECOPD) are responsible for up to 70% of COPD-related healthcare costs; hospital readmissions alone account for over $15 billion annually. In this review, we aim to describe insights about the economic impact of COPD readmissions based on articles published over the last 18 months. Recent findings Interventions aimed at reducing readmission, particularly those using interdisciplinary teams with bundled care interventions, were uniformly successful at improving the quality of care provided and demonstrating improved process measures. However, success at reducing readmissions and cost savings based on these interventions varied across the studies. Summary The literature to date points to factors and conditions that may place patients at higher risk of readmissions and may lead to higher costs. Interventions aimed at reducing readmissions after index admissions for AECOPD have demonstrated variable results. Most interventions did not reflect cost-based analyses.

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