Krishnan Jerry A, Gussin Hélène A, Prieto-Centurion Valentin, Sullivan Jamie L, Zaidi Farhan, Thomashow Byron M
Population Health Sciences Program. University of Illinois Hospital & Health Sciences System, Chicago ; Department of Medicine, Section of Pulmonary, Critical Care, Sleep and Allergy Medicine, University of Illinois at Chicago.
Department of Medicine, Section of Pulmonary, Critical Care, Sleep and Allergy Medicine, University of Illinois at Chicago.
Chronic Obstr Pulm Dis. 2015;2(1):70-80. doi: 10.15326/jcopdf.2.1.2014.0148.
About 1 in 5 patients hospitalized for exacerbations of chronic obstructive pulmonary disease (COPD) in the United States are readmitted within 30 days. The U.S. Centers for Medicare and Medicaid Services has recently expanded its Hospital Readmissions Reduction Program to financially penalize hospitals with higher than expected all-cause 30-day readmission rates following a hospitalization for COPD exacerbation. In October 2013, the COPD Foundation convened a multi-stakeholder National COPD Readmissions Summit to summarize our understanding of how to reduce hospital readmissions in patients hospitalized for COPD exacerbations. Over 225 individuals participated in the Summit, including patients, clinicians, health service researchers, policy makers and representatives of academic health care centers, industry, and payers. Summit participants recommend that programs to reduce hospital readmissions: 1) Include specific recommendations about how to promote COPD self-management skills training for patients and their caregivers; 2) Adequately address co-existing disorders common to COPD in care plans during and after hospitalizations; 3) Include an evaluation of adverse events when implementing strategies to reduce hospital readmissions; and 4) Develop a strategy (e.g., a learning collaboratory) to connect groups who are engaged in developing, testing, and implementing programs to reduce hospital readmissions for COPD and other conditions.
在美国，因慢性阻塞性肺疾病（COPD）急性加重而住院的患者中，约五分之一会在30天内再次入院。美国医疗保险和医疗补助服务中心最近扩大了其医院再入院减少计划，对COPD急性加重住院后30天全因再入院率高于预期的医院进行经济处罚。2013年10月，COPD基金会召开了一次多利益相关方的全国COPD再入院峰会，以总结我们对如何减少因COPD急性加重而住院患者的医院再入院情况的理解。超过225人参加了此次峰会，包括患者、临床医生、卫生服务研究人员、政策制定者以及学术医疗中心、行业和支付方的代表。峰会参与者建议，减少医院再入院的计划应：1）包括关于如何促进对患者及其护理人员进行COPD自我管理技能培训的具体建议；2）在住院期间及出院后的护理计划中充分解决COPD常见的并存疾病；3）在实施减少医院再入院的策略时纳入不良事件评估；4）制定一项策略（例如学习协作平台），将参与制定、测试和实施减少COPD及其他疾病医院再入院计划的各方联系起来。
