Chronic Obstructive Pulmonary Disease Readmissions and Other Measures of Hospital Quality.
The Centers for Medicare and Medicaid Services recently implemented financial penalties to reduce hospital readmissions for select conditions, including chronic obstructive pulmonary disease (COPD). Despite growing pressure to reduce COPD readmissions, it is unclear how COPD readmission rates are related to other measures of quality, which could inform efforts on common organizational factors that affect high-quality care.



To examine the association between COPD readmissions and other quality measures.



We analyzed data from the 2015 Centers for Medicare and Medicaid Services annual files, downloaded from the Hospital Compare website. We included 3,705 hospitals nationwide that had publically reported data on COPD readmissions. We compared COPD readmission rates to other risk-adjusted measures of quality, including readmission and mortality rates for other conditions, and patient reports about care experiences.



There were modest correlations between COPD readmission rates and readmission rates for other medical conditions, including heart failure (r = 0.39; P < 0.01), acute myocardial infarction (r = 0.30; P < 0.01), pneumonia (r = 0.38; P < 0.01), and stroke (r = 0.29; P < 0.01). In contrast, we found low correlations between COPD readmission rates and readmission rates for surgical conditions, as well as mortality rates for all measured conditions. There were significant correlations between COPD readmission rates and all patient experience measures.



These findings suggest there may be common organizational factors that influence multiple disease-specific outcomes. As pay-for-performance programs focus attention on individual disease outcomes, hospitals may benefit from in-depth assessments of organizational factors that affect multiple aspects of hospital quality.
1 Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Department of Veterans Affairs, Bedford, Massachusetts.|2 Department of Medicine, Section of Pulmonary, Allergy, Sleep, and Critical Care Medicine, Boston University, Boston, Massachusetts.
Seppo T
ST
Rinne
3 Department of Medicine, Division of Pulmonary Diseases and Critical Care Medicine, University of Texas Health Science Center, San Antonio, Texas.
Jose
J
Castaneda
4 Center for Quality of Care Research, Division of Hospital Medicine, Baystate Medical Center, Springfield, Massachusetts.|5 Section of General Internal Medicine, Department of Medicine, Tufts University School of Medicine, Medford, Massachusetts.
Peter K
PK
Lindenauer
6 Yale School of Public Health, New Haven, Connecticut.
Paul D
PD
Cleary
7 Aetna, Inc., Hartford, Connecticut; and.|8 Department of Medicine, Section of Pulmonary, Critical Care, and Sleep Medicine, Yale University, New Haven, Connecticut.
Harold L
HL
Paz
8 Department of Medicine, Section of Pulmonary, Critical Care, and Sleep Medicine, Yale University, New Haven, Connecticut.
Jose L
JL
Gomez
D014487:Centers for Medicare and Medicaid Services, U.S.; D006761:Hospitals / Q000592:standards* / Q000706:statistics & numerical data*; D006801:Humans; D010359:Patient Readmission / Q000706:statistics & numerical data*; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology* / Q000628:therapy; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology
chronic obstructive pulmonary disease; health care; patient readmission; quality indicators