Background: Chronic Obstructive Pulmonary Disease (COPD) is the third most common cause of hospital readmission within 30 days of discharge. These readmissions increase the overall healthcare cost burden. We examined the effect of early follow-up visit with patient’s primary care physician (PCP) or pulmonologist on 30-day and 1-year readmission risk.
Methods: We constructed an electronic retrospective cohort of all patients hospitalized for COPD between September 2013 and September 2015. Socioeconomic characteristics, medical comorbidities, PCP and pulmonologist follow-ups were assessed for effect on readmission. Readmission, defined as one or more hospitalizations, were assessed at 30 days and at 1 year after initial hospitalization.
Results: During the study period a total of 1,607 patients were admitted with COPD. 49.2% of patients had no follow-up appointments within 30 days of discharge. The overall readmission rate was 10.6% in 30-days and 34% in 1 year. Gender and race had no association with the likelihood of readmission. Patients who were hospitalized for more than 4 days were more likely to be readmitted at 30-days (p < 0.05) and at 1-year (p < 0.001). While patients who had at least one visit with their primary care provider (PCP) were less likely to be readmitted at 1-year (p < 0.001), early PCP appointments, within one month of hospitalization, had no effect on likelihood of readmission at 30 days or 1 year. On the other hand, seeing a pulmonologist, within a month of hospitalization, significantly decreases the likelihood of getting readmitted at 30 days (p <0.001) and at 1 year (p < 0.05).
Conclusions: Early outpatient follow-up with pulmonary medicine, after COPD hospitalization, significantly reduces risk of readmission at 30-days and 1 year.