Date of Conferral

2020

Degree

Ph.D.

School

Public Health

Advisor

Mary Lou Gutierrez

Abstract

Patients suffering from chronic obstructive pulmonary disease (COPD) not only face difficulties managing their disease but are also faced with a higher risk of being readmitted to a hospital after an initial visit for acute exacerbation of their condition. Despite hospitals’ many attempts to offset this burden, readmission reduction programs are not effective. The purpose of this quantitative study was to further research an organization’s specific population surrounding patient comorbidities, reasons for readmissions, and demographic characteristics that may lend insight into reasons for readmissions. The research design was a retrospective analysis of a health system’s electronic medical record with a 3 manuscript approach. A sample of more than 800 COPD inpatients discharged over an 18-month period were examined for these studies using a variety of methods such logistic regression and survival analysis. Of the top 10 comorbid conditions identified, only those with acute and chronic respiratory failure with hypoxia were significantly more likely to be readmitted within 30 days (odds ratio = 2.38), and patients who were readmitted were most likely to come back for a respiratory condition, including COPD exacerbation. Although most demographic factors did not show statistical significance, readmissions were more likely among those discharged to home versus a skilled nursing facility or those who had a Medicare fee-for-service payor type. Further research into more clinical data versus administrative data can lend additional insights into further risk factors. These findings could lead to the development of more direct and effective readmission reduction strategies that enhance the quality of care for patients.

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