Date of Conferral



Doctor of Healthcare Administration (D.H.A.)


Health Services


Miriam Ross


AbstractRates for chronic obstructive pulmonary disease (COPD) have continued to increase, resulting in readmission tracking by the Centers for Medicare and Medicaid for community hospitals and Veterans Health Administration (VHA) hospitals. By using the Andersen healthcare utilization model as the theoretical framework, the purpose of this quantitative correlational research was to examine differences in 4,879 COPD readmission and mortality rates in VHA hospitals for the four Veteran Administration (VA) regional districts—Northeast, Southeast, Continental, and Pacific—as well as and between rural and urban VA hospitals. Secondary data was acquired from an open website through the Centers for Medicare & Medicaid Services. Using one-way analysis of variance (ANOVA) tests, Research Questions 1 and 2 addressed the four VHA regions concerning COPD mortality rates and readmission rates, but there were no statistical differences. An independent t test addressed Research Questions 3 and 4 to determine differences with COPD mortality and readmission rates in urban and rural VA hospitals, but again no statistical differences were found. Using a regression analysis, the fifth research question addressed 30-day readmission rates and 30-day mortality rates in urban and rural VA hospitals, which did show a significant association, as mortality rates were higher in urban rather versus rural VA hospitals. This study will promote positive social change by providing hospital administrators and researchers a clearer understanding of the concerns associated with COPD mortality rates in rural and urban VA hospitals. With this understanding, developing programs that address the unique needs of these populations may strengthen patient outcomes, policies, and protocols.