1 Department of Medicine, Section of Pulmonary, Critical Care, Sleep and Allergy Medicine, University of Illinois at Chicago, Chicago, Illinois; and.
Ann Am Thorac Soc. 2013 Dec;10(6):680-4. doi: 10.1513/AnnalsATS.201307-223OT.
About 20% of patients hospitalized for chronic obstructive pulmonary disease (COPD) exacerbations are readmitted within 30 days. High 30-day risk-standardized readmission rates after COPD exacerbations will likely place hospitals at risk for financial penalties from the Centers for Medicare and Medicaid Services starting in fiscal year 2015. Factors contributing to hospital readmissions include healthcare quality, access to care, coordination of care between hospital and ambulatory settings, and factors linked to socioeconomic resources (e.g., social support, stable housing, transportation, and food). These concerns are exacerbated at minority-serving institutions, which provide a disproportionate share of care to patients with low socioeconomic resources. Solutions tailored to the needs of minority-serving institutions are urgently needed. We recommend research that will provide the evidence base for strategies to reduce readmissions at minority-serving institutions. Promising innovative approaches include using a nontraditional healthcare workforce, such as community health workers and peer-coaches, and telemedicine. These strategies have been successfully used in other conditions and need to be studied in patients with COPD.
约 20%因慢性阻塞性肺疾病（COPD）恶化而住院的患者在 30 天内再次入院。高 30 天风险标准化 COPD 恶化后再入院率可能会使医院面临自 2015 财年起，来自医疗保险和医疗补助服务中心的财务处罚风险。导致医院再次入院的因素包括医疗质量、获得医疗服务的机会、医院和门诊环境之间的护理协调以及与社会经济资源相关的因素（例如社会支持、稳定的住房、交通和食物）。这些问题在为低社会经济资源患者提供服务的少数族裔服务机构中更为严重。迫切需要针对少数族裔服务机构需求制定的解决方案。我们建议开展研究，为减少少数族裔服务机构再入院的策略提供证据基础。有前途的创新方法包括使用非传统医疗保健劳动力，如社区卫生工作者和同伴教练以及远程医疗。这些策略已在其他疾病中成功应用，需要在 COPD 患者中进行研究。
