Risks for Readmission Among Older Patients With Chronic Obstructive Pulmonary Disease: An Analysis Using Korean National Health Insurance Service – Senior Cohort Data
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Objectives: The high readmission rate of patients with chronic obstructive pulmonary disease (COPD) has led to the worldwide establishment of proactive measures for identifying and mitigating readmissions. This study aimed to identify factors associated with readmission, as well as groups particularly vulnerable to readmission that require transitional care services.Methods: To apply transitional care services that are compatible with Korea’s circumstances, targeted groups that are particularly vulnerable to readmission should be identified. Therefore, using the National Health Insurance Service’s Senior Cohort database, we analyzed data from 4874 patients who were first hospitalized with COPD from 2009 to 2019 to define and analyze readmissions within 30 days after discharge. Logistic regression analysis was performed to determine factors correlated with readmission within 30 days.Results: The likelihood of readmission was associated with older age (for individuals in their 80s vs. those in their 50s: odds ratio [OR], 1.59; 95% confidence interval [CI], 1.19 to 2.12), medical insurance type (for workplace subscribers vs. local subscribers: OR, 0.84; 95% CI, 0.72 to 0.99), type of hospital (those with 300 beds or more vs. fewer beds: OR, 0.77; 95% CI, 0.66 to 0.90), and healthcare organization location (provincial areas vs. the capital area: OR, 1.66; 95% CI, 1.14 to 2.41).Conclusions: Older patients, patients holding a local subscriber insurance qualification, individuals admitted to hospitals with fewer than 300 beds, and those admitted to provincial hospitals are suggested to be higher-priority for transitional care services.
Abstract
Objectives: The high readmission rate of patients with chronic obstructive pulmonary disease (COPD) has led to the worldwide establishment of proactive measures for identifying and mitigating readmissions. This study aimed to identify factors associated with readmission, as well as groups particularly vulnerable to readmission that require transitional care services.Methods: To apply transitional care services that are compatible with Korea’s circumstances, targeted groups that are particularly vulnerable to readmission should be identified. Therefore, using the National Health Insurance Service’s Senior Cohort database, we analyzed data from 4874 patients who were first hospitalized with COPD from 2009 to 2019 to define and analyze readmissions within 30 days after discharge. Logistic regression analysis was performed to determine factors correlated with readmission within 30 days.Results: The likelihood of readmission was associated with older age (for individuals in their 80s vs. those in their 50s: odds ratio [OR], 1.59; 95% confidence interval [CI], 1.19 to 2.12), medical insurance type (for workplace subscribers vs. local subscribers: OR, 0.84; 95% CI, 0.72 to 0.99), type of hospital (those with 300 beds or more vs. fewer beds: OR, 0.77; 95% CI, 0.66 to 0.90), and healthcare organization location (provincial areas vs. the capital area: OR, 1.66; 95% CI, 1.14 to 2.41).Conclusions: Older patients, patients holding a local subscriber insurance qualification, individuals admitted to hospitals with fewer than 300 beds, and those admitted to provincial hospitals are suggested to be higher-priority for transitional care services.
참고문헌 (30)
- Varmaghani M, "Global prevalence of chronic obstructive pulmonary disease : systematic review and meta-analysis", East Mediterr Health J, 25(1), pp.47~57 (2019)
- "Chronic obstructive pulmonary disease (COPD)" (2023)[URL]
- Cho KS, "Current status of chronic obstructive pulmonary disease(COPD)in the Republic of Korea", Public Health Wkly Rep, 14(16), pp.943~951 (2021)
- "Practice guidelines: COPD guideline revised 2018"[URL]
- Bourbeau J, "Making collaborative self-management successful in COPD patients with high disease burden", Respir Med, 107(7), pp.1061~1065 (2013)
- Alqahtani JS, "Risk factors for all-cause hospital readmission following exacerbation of COPD : a systematic review and meta-analysis", Eur Respir Rev, 29(156), pp.190166~ (2020)
- Schoenbaum SC, "Mortality amenable to health care in United States : the roles of demographics and health systems performance", J Public Health Policy, 32(4), pp.407~429 (2011)
- Almagro P, "Risk factors for hospital readmission in patients with chronic obstructive pulmonary disease", Respiration, 73(3), pp.311~317 (2006)
- Benbassat J, "Hospital readmissions as a measure of quality of health care : advantages and limitations", Arch Intern Med, 160(8), pp.1074~1081 (2000)
- "The result of the risk-standardized readmission rate of 2017 (2nd)" (2018)[URL]
- "OECD reviews of public health: Korea: a healthier tomorrow" (2020)[URL]
- Cox JC, "Incentivizing cost-effective reductions in hospital readmission rates", J Econ Behav Organ, 131(B), pp.24~35 (2016)
- Nolte E, "Preventing emergency readmissions to hospital : a scoping review", Rand Health Q, 2(1), pp.10~ (2012)
- "All-cause readmission to acute care and return to the emergency department" (2012)[URL]
- Naylor MD, "Transitions theory: middle-range and situation-specific theories in nursing research and practice", pp.459~465 (2012), Springer Publishing
- Kim TW, "The association with COPD readmission rate and access to medical institutions in elderly patients", Int J Chron Obstruct Pulmon Dis, 16, pp.1599~1606 (2021)
- "Sample research DB"[URL]
- "Korean Standard Classification of Disease (KCD) version 7" (2015)[URL]
- Njoku CM, "Risk factors and associated outcomes of hospital readmission in COPD : a systematic review", Respir Med, 173, pp.105988~ (2020)
- Press VG, "Reducing chronic obstructive pulmonary disease hospital readmissions. An official American Thoracic Society workshop report", Ann Am Thorac Soc, 16(2), pp.161~170 (2019)
- Sharma G, "Outpatient follow-up visit and 30-day emergency department visit and readmission in patients hospitalized for chronic obstructive pulmonary disease", Arch Intern Med, 170(18), pp.1664~1670 (2010)
- Portillo EC, "Reducing COPD readmission rates : using a COPD care service during care transitions", Fed Pract, 35(11), pp.30~36 (2018)
- Baker CL, "Risk assessment of readmissions following an initial COPD-related hospitalization", Int J Chron Obstruct Pulmon Dis, 8, pp.551~559 (2013)
- Krumholz HM, "Hospital-readmission risk-isolating hospital effects from patient effects", N Engl J Med, 377(11), pp.1055~1064 (2017)
- 정상미, "Evaluation of Appropriate Management of Chronic Obstructive Pulmonary Disease in Korea: Based on Health Insurance Review and Assessment Service (HIRA) Claims", Tuberculosis and Respiratory Diseases, 80(3), pp.241~246 (2017), 대한결핵및호흡기학회
- Nantsupawat T, "Factors affecting chronic obstructive pulmonary disease early rehospitalization", Chron Respir Dis, 9(2), pp.93~98 (2012)
- Sharma G, "Outpatient follow-up visit and 30-day emergency department visit and readmission in patients hospitalized for chronic obstructive pulmonary disease", Arch Intern Med, 170(18), pp.1664~1670 (2010)
- Lee J, "Urban-rural differences in intention to age in place while receiving home care srvices : findings from the National Survey of Older Koreans", Arch Gerontol Geriatr, 101, pp.104690~ (2022)
- Rinne ST, "Chronic obstructive pulmonary disease readmissions and other measures of hospital quality", Am J Respir Crit Care Med, 196(1), pp.47~55 (2017)
- Agusti A, "COPD as a systemic disease", COPD, 5(2), pp.133~138 (2008)