A study found no decreases in readmissions following chronic obstructive pulmonary disease (COPD) hospitalizations, even after financial penalties by way of the Hospital Readmission Reduction Program (HRRP) were imposed on hospitals with higher-than-expected risk-adjusted 30-day readmission rates for Medicare beneficiaries. The study was published in the Annals of the American Thoracic Society.
In this study, researchers used data from California’s Office of Statewide Health Planning and Development to examine unplanned 30-day all-cause and COPD-related readmissions after COPD hospitalization. Data were assessed over three periods: the pre-announcement (of imposed penalties) period from January 2010 to July 2013, the post-announcement period from August 2013 to September 2014, and the post-enactment period from October 2014 to December 2017. In total, they analyzed 333,429 hospitalizations for COPD from 449 hospitals. The researchers noted that almost 70% of patients had Medicare insurance.
The results of the study showed for patients with COPD-related readmissions, the level change at the time of the announcement was 0.09% (95% confidence interval [CI], –0.68 to 0.85; P=0.83); the change in slope was 0.003% (95% CI –0.08 to 0.09; P=0.94). The level change in readmissions at the time of HHRP enactment was 0.22% (95% CI –0.69 to 1.12; P=0.64); the change in slope was –0.02% (95% CI, –0.10 to 0.07; P=0.72).
“We did not detect decreases in either all-cause or COPD-related readmission rates at either timepoint,” the researchers concluded. “Based on this, we believe early, broad interventions decreased readmissions, such that no difference was seen at this later timepoints despite institution of COPD-specific penalties.”
Keywords: COPD, Hospital Readmission Reduction Program, Medicare