COPD patients are often hospitalized due to exacerbations caused by the disease. Some common reasons for these exacerbations include worsened disease, pneumonia, and respiratory infections. Patients are often discharged after the acute crisis is over in the hope that they will remain stable after hospitalization.
A recent study out of the Soroka University Medical Center in Israel, published in the journal Chest and entitled “The Association Between Hospital Readmission and Pulmonologist Follow-up Visits in Patients With COPD,” indicates that this sense of stability may not be accurate. The researchers studied 195 patients with COPD who had been hospitalized with COPD-related illnesses in a population-based retrospective clinical study. They noted that only about 44 percent of these individuals saw a pulmonologist within 30 days of being hospitalized for their condition.
They also noted that those who saw their pulmonologist within 30 days of discharge were significantly less likely to be readmitted to the hospital after 90 days post-discharge. The reasons for this was not speculated upon, but could be due to changes in medications after discharge affecting outcome or evaluation by the pulmonologist of worsened COPD symptoms.
Those who failed to see the pulmonologist after being discharged from the hospital were more likely to live further away than 30 kilometers from the clinic, which might be a reason for their failure to show up for a pulmonology appointment after being hospitalized. Many COPD patients are on oxygen therapy so that traveling long distances can be difficult.
Because the rate of readmission of COPD patients after hospitalization is so high, and because re-hospitalization reduces their quality of life and places a burden on healthcare resources, it is recommended by the researchers that all patients with COPD get reevaluated by a pulmonologist as part of their COPD management within 30 days of discharge.
How can health professionals ensure that COPD patients see the pulmonologist after being discharged from the hospital? It was recommended by the research study that all people discharged with a diagnosis of COPD have a written recommendation in their letter of discharge from the hospital advising them to see their pulmonologist shortly after discharge from the hospital–especially within a month of discharge. The extra reminder can encourage COPD patients or their family members to make the appointment and could further emphasize the importance of these kinds of visits.
COPD hospital readmission remains a major issue associated with the disease, reducing patients’ quality of life and increasing the burden on healthcare resources to handle the high COPD readmission rate. As COPD patients face a chronic condition with expected exacerbation of their disease, frequent visits to the pulmonologist are recommended, especially following a hospitalization. These patients need to make sure the condition that caused their hospitalization has resolved and that their disease has returned to its stable state. If hospital readmissions can be curtailed through increased outpatient visits to specialists, it will offer a benefit to both patients and healthcare organizations alike.
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