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利用基于证据的 COPD 护理包降低医院再入院率。

Decreasing Hospital Readmissions Utilizing an Evidence-Based COPD Care Bundle.

机构信息

Atlantic Health System, Morristown, NJ, USA.

Morristown Medical Center, Morristown, NJ, USA.

出版信息

Lung. 2022 Aug;200(4):481-486. doi: 10.1007/s00408-022-00548-9. Epub 2022 Jul 7.

Abstract

PURPOSE

Chronic obstructive pulmonary disease (COPD) is a chronic condition that leads to significant morbidity and mortality. Management of COPD hospitalizations utilizing an evidence-based care bundle can provide consistent quality of care and may reduce readmissions.

METHODS

This single-center retrospective cohort study evaluated readmission rates in patients hospitalized with a COPD exacerbation. Patients in the pre-intervention cohort received usual care, while patients in the post-intervention cohort received an innovative inpatient COPD care bundle. The bundle focused on optimizing care in five areas: consults, inpatient interventions, education, transitions of care, and after discharge care.

RESULTS

In this study, 149 subjects were included in the pre-intervention cohort and 214 subjects were included in the post-intervention cohort. Thirty-day readmission rates were lower in the post-intervention cohort compared to the pre-intervention cohort, 22.4% vs. 38.3% (p = 0.001). A reduction in 60-day and 90-day readmission rates was also observed, 13.7% vs. 40.3% (p < 0.001) and 10.1% vs. 32.2% (p < 0.001), respectively.

CONCLUSION

Bundled care is an effective and inexpensive method for institutions to provide consistent and quality care. The findings of this study demonstrate that the implementation of a COPD care bundle is an effective strategy to decrease hospital readmissions.

摘要

目的

慢性阻塞性肺疾病(COPD)是一种导致严重发病率和死亡率的慢性疾病。利用循证护理包管理 COPD 住院治疗可以提供一致的护理质量,并可能降低再入院率。

方法

这项单中心回顾性队列研究评估了 COPD 加重住院患者的再入院率。干预前队列中的患者接受常规护理,而干预后队列中的患者接受创新的住院 COPD 护理包。该护理包专注于优化五个方面的护理:咨询、住院干预、教育、护理交接和出院后护理。

结果

本研究中,干预前队列纳入 149 例患者,干预后队列纳入 214 例患者。与干预前队列相比,干预后队列的 30 天再入院率较低,分别为 22.4%和 38.3%(p=0.001)。还观察到 60 天和 90 天再入院率的降低,分别为 13.7%和 40.3%(p<0.001)以及 10.1%和 32.2%(p<0.001)。

结论

捆绑式护理是机构提供一致和高质量护理的有效且廉价的方法。本研究的结果表明,实施 COPD 护理包是降低医院再入院率的有效策略。

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