Hospital Readmission Due to Chronic Obstructive Pulmonary Disease: A Longitudinal Study

Background  This study aimed to investigate the prevalence of hospital readmission for chronic obstructive pulmonary disease (COPD) at ۳۰, ۹۰ and ۳۶۵ days, and to determine demographic and socioeconomic risk factors for ۳۰-day and ۹۰-day readmission and time to COPD-related readmission within ۳۶۵ days in Tasmania.Methods  Patients ≥۴۰ years admitted for COPD between ۲۰۱۱ and ۲۰۱۵ were identified using administrative data from all major public hospitals in Tasmania, Australia. Factors associated with readmission and time to readmission were identified using logistic and Cox regression, respectively.Results  The rates of COPD-related readmission were ۶.۷% within ۳۰ days, ۱۲.۲% within ۹۰ days and ۲۳.۷% within ۳۶۵ days. Being male (odds ratio [OR]: ۱.۴۹, CI: ۱.۰۶–۲.۰۹), Indigenous (OR: ۲.۴۷, CI: ۱.۳۱–۴.۶۶) and living in the lower socioeconomic North-West region of Tasmania (OR: ۱.۸۰, CI: ۱.۲۰–۲.۶۹) were risk factors for ۳۰-day readmission. Increased COPD-related (OR: ۱.۴۸, CI: ۱.۲۲–۱.۸۰; OR: ۱.۵۲, CI: ۱.۲۹–۱.۷۸) and non-COPD-related (OR: ۱.۱۲, CI: ۱.۰۳–۱.۲۳; OR: ۱.۱۱, CI: ۱.۰۳–۱.۲۱) emergency department (ED) visits in the preceding six months were risk factors for both ۳۰-day and ۹۰-day readmissions. Being Indigenous (hazard ratio [HR]: ۱.۶۱, CI: ۱.۱۰–۲.۳۷) and previous COPD-related ED visits (HR: ۱.۳۰, CI: ۱.۲۱–۱.۳۹) decreased, while a higher Charlson Comorbidity Index (CCI) (OR: ۰.۹۱, CI: ۰.۸۳–۰.۹۹) increased the time to readmission within ۳۶۵ days.Conclusion  Being male, Indigenous, living in the North-West region and previous ED visits were associated with increased risk of COPD readmission in Tasmania. Interventions to improve access to primary healthcare for these groups may reduce COPD-related readmissions.

Keywords:

COPD , Patient readmission , Prevalence , Risk Factors