TY - JOUR
T1 - Association between inpatient palliative care encounter and 30-day all-cause readmissions after index hospitalization for chronic obstructive pulmonary disease
AU - Yazdanyar, Ali
AU - Vojtek, Ashley
AU - Gupta, Sachin
AU - Iyer, Aditya
AU - Kears, Alaynna C.
AU - Musco, Kaitlyn
AU - Li, Shuisen
AU - Jarjous, Shadi
N1 - Funding Information:
We conducted a cross-sectional study using the 2010–2014 Nationwide Readmissions Database (NRD). Briefly, NRD is a publicly available database sponsored by the Agency for Healthcare Research and Quality.26 It includes approximately 28 million annual hospital discharges along with linkage numbers allowing patient tracking for readmission within the same calendar year.
Publisher Copyright:
© 2022 Elsevier Inc.
PY - 2023/3/1
Y1 - 2023/3/1
N2 - Background: Studies exist on the association between inpatient Palliative Care Encounter (iPCE) and 30-day rehospitalization among cancer and several non-cancer conditions but limited in persons with Chronic Obstructive Pulmonary Disease (COPD). Objective: To assess the association between an iPCE with the risk of 30-day rehospitalization after an index hospitalization for COPD. Methods: We conducted a cross-sectional analysis of the Nationwide Readmissions Database (2010–2014). Index hospitalizations were defined as persons ≥ 18 years of age, discharge destinations of either Home/Routine, Home with Home Care, or a Facility, and an index hospitalization with Diagnosis Related Group of COPD. The International Classification of Diseases, 9th revision codes were used to extract comorbidities and a Palliative Care Encounter (V66.7). Results: There were 3,163,889 index hospitalizations and iPCE occurred in 21,330 (0.67%). There were 558,059 (17.63%) with a 30-day rehospitalization. An iPCE was associated with a significantly lower adjusted odds of 30-day readmission (Odds Ratio [OR], 0.50; 95% Confidence Interval [CI], 0.46 to 0.54). By discharge destination, the odds of 30-day rehospitalization were for a discharged to a facility (OR, 0.37; 95% CI, 0.32 to 0.42), to home with home health (OR, 0.42; 95% CI, 0.37 to 0.47), and to home (OR, 0.98; 95% CI, 0.85 to 1.12) for those with relative to without iPCE. Conclusion: Inpatient PCE was associated with a 50% lower relative odds of 30-day rehospitalization after an index hospitalization for COPD. This association varied by discharge destination being statistically significant among those with a discharge destination of a facility (63%) and home with home care (58%).
AB - Background: Studies exist on the association between inpatient Palliative Care Encounter (iPCE) and 30-day rehospitalization among cancer and several non-cancer conditions but limited in persons with Chronic Obstructive Pulmonary Disease (COPD). Objective: To assess the association between an iPCE with the risk of 30-day rehospitalization after an index hospitalization for COPD. Methods: We conducted a cross-sectional analysis of the Nationwide Readmissions Database (2010–2014). Index hospitalizations were defined as persons ≥ 18 years of age, discharge destinations of either Home/Routine, Home with Home Care, or a Facility, and an index hospitalization with Diagnosis Related Group of COPD. The International Classification of Diseases, 9th revision codes were used to extract comorbidities and a Palliative Care Encounter (V66.7). Results: There were 3,163,889 index hospitalizations and iPCE occurred in 21,330 (0.67%). There were 558,059 (17.63%) with a 30-day rehospitalization. An iPCE was associated with a significantly lower adjusted odds of 30-day readmission (Odds Ratio [OR], 0.50; 95% Confidence Interval [CI], 0.46 to 0.54). By discharge destination, the odds of 30-day rehospitalization were for a discharged to a facility (OR, 0.37; 95% CI, 0.32 to 0.42), to home with home health (OR, 0.42; 95% CI, 0.37 to 0.47), and to home (OR, 0.98; 95% CI, 0.85 to 1.12) for those with relative to without iPCE. Conclusion: Inpatient PCE was associated with a 50% lower relative odds of 30-day rehospitalization after an index hospitalization for COPD. This association varied by discharge destination being statistically significant among those with a discharge destination of a facility (63%) and home with home care (58%).
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U2 - 10.1016/j.hrtlng.2022.11.003
DO - 10.1016/j.hrtlng.2022.11.003
M3 - Article
C2 - 36410155
AN - SCOPUS:85142180924
SN - 0147-9563
VL - 58
SP - 69
EP - 73
JO - Heart and Lung
JF - Heart and Lung
ER -