Budde Julia, Agarwal Parul, Mazumdar Madhu, Braman Sidney S
Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
Institute for Health Care Delivery Science at Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York.
Chronic Obstr Pulm Dis. 2019 Apr 9;6(2):129-131. doi: 10.15326/jcopdf.6.2.2018.0149.
We evaluated whether visiting a primary care provider (PCP) or medical subspecialist within 10 days of discharge reduces 30-day readmissions following hospitalization for acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Data were retrospectively collected from electronic health records for AECOPD-related hospitalizations at an urban, academic medical center for patients 40 years of age or older between June 2011 and June 2016. Primary outcome was probability of all-cause 30-day readmission. Follow-up was defined as visiting a PCP or any medical subspecialist within 10 days of discharge. Generalized linear mixed models were used to examine the association between hospital readmissions and a visit to a PCP or medical subspecialist. Of the 2653 hospital discharges, 17.6% (n=468) had a 30-day readmission. Follow-up did not affect 30-day readmission risk (adjusted odds ratio 1.14; 95% confidence interval 0.89, 1.47). Prompt follow-up is not associated with a reduced risk of 30-day readmission following AECOPD, highlighting the need for a comprehensive approach to chronic obstructive pulmonary disease (COPD).
我们评估了在出院后10天内就诊于初级保健提供者（PCP）或医学专科医生是否会降低慢性阻塞性肺疾病急性加重（AECOPD）住院后的30天再入院率。数据是从2011年6月至2016年6月期间，一家城市学术医疗中心40岁及以上患者与AECOPD相关住院的电子健康记录中回顾性收集的。主要结局是全因30天再入院的概率。随访定义为在出院后10天内就诊于PCP或任何医学专科医生。使用广义线性混合模型来检验医院再入院与就诊于PCP或医学专科医生之间的关联。在2653例出院病例中，17.6%（n = 468）有30天再入院情况。随访并未影响30天再入院风险（调整后的优势比为1.14；95%置信区间为0.89, 1.47）。AECOPD后及时随访与降低30天再入院风险无关，这凸显了对慢性阻塞性肺疾病（COPD）采取综合治疗方法的必要性。
