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

Document Type : Original Article

Authors

1 School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia

2 School of Nursing and Midwifery, University of Newcastle, Port Macquarie, NSW, Australia

3 Tasmanian School of Medicine, College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia

Abstract

Background 
This study aimed to investigate the prevalence of hospital readmission for chronic obstructive pulmonary disease (COPD) at 30, 90 and 365 days, and to determine demographic and socioeconomic risk factors for 30-day and 90-day readmission and time to COPD-related readmission within 365 days in Tasmania.

Methods 
Patients ≥40 years admitted for COPD between 2011 and 2015 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 6.7% within 30 days, 12.2% within 90 days and 23.7% within 365 days. Being male (odds ratio [OR]: 1.49, CI: 1.06–2.09), Indigenous (OR: 2.47, CI: 1.31–4.66) and living in the lower socioeconomic North-West region of Tasmania (OR: 1.80, CI: 1.20–2.69) were risk factors for 30-day readmission. Increased COPD-related (OR: 1.48, CI: 1.22–1.80; OR: 1.52, CI: 1.29–1.78) and non-COPD-related (OR: 1.12, CI: 1.03–1.23; OR: 1.11, CI: 1.03–1.21) emergency department (ED) visits in the preceding six months were risk factors for both 30-day and 90-day readmissions. Being Indigenous (hazard ratio [HR]: 1.61, CI: 1.10–2.37) and previous COPD-related ED visits (HR: 1.30, CI: 1.21–1.39) decreased, while a higher Charlson Comorbidity Index (CCI) (OR: 0.91, CI: 0.83–0.99) increased the time to readmission within 365 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


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Articles in Press, Corrected Proof
Available Online from 09 January 2022
  • Receive Date: 07 December 2020
  • Revise Date: 15 September 2021
  • Accept Date: 08 January 2022