Readmissions after hospital discharge with acute exacerbation of COPD: are we missing something?
Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is an important part of the disease's morbidity, mortality, and progression, and is associated with increasing utilization of health care resources. The concept of integrated care based on a chronic care model is relatively new to chronic obstructive pulmonary disease, but has proved successful in improving clinical outcomes and probably in decreasing health care utilization in other chronic conditions. A comprehensive approach is needed to target a change in behavioral patterns in patients, increase physician's awareness and adherence to evidence-based recommendations, and address system related issues. This article discusses the evidence for various facets of nonpharmacological management of AECOPD and proposes a model of care that might be the missing link for reducing hospital readmissions for AECOPD. This model may decrease the morbidity, slow disease progression, and curb the increasing health care resource utilization without compromising patient care.
Fellow, Division of Pulmonary and Critical Care, Thomas Jefferson University, Philadelphia, PA.
Kumar
K
Gaurav
Urvashi
U
Vaid
William
W
Sexauer
Mani S
MS
Kavuru
D000367:Age Factors; D001364:Awareness; D015897:Comorbidity; D003266:Continuity of Patient Care / Q000458:organization & administration*; D018450:Disease Progression; D005541:Forced Expiratory Volume; D019983:Guideline Adherence / Q000458:organization & administration; D015438:Health Behavior; D006304:Health Status; D006801:Humans; D010349:Patient Compliance; D010351:Patient Discharge; D010353:Patient Education as Topic / Q000458:organization & administration; D010359:Patient Readmission / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy / Q000628:therapy*; D012307:Risk Factors; D012648:Self Care; D012944:Social Support; D012959:Socioeconomic Factors