The Science Journal of the American Association for Respiratory Care

2012 OPEN FORUM Abstracts


Brian W. Carlin1, Dan Easley2, Kim Wiles2; 1Sleep Medicine and Lung Health Consultants, Ingomar, PA; 2Klingensmith HealthCare, Ford City, PA

Abstract Background: The overall 30 day readmission rate for patients who have been hospitalized following hospitalization for a COPD exacerbation approaches twenty five percent in Western Pennsylvania. A patientÂ’s appointment with the primary care provider soon after the hospital discharge has been suggested as a means to help to reduce the 30 day readmission rates. Objective: To measure the effect of a patient-physician visit following discharge for patients requiring supplemental oxygen therapy on 30 day rehospitalization rates. Methods: Patients with a COPD exacerbation who required supplement oxygen therapy on hospital discharge were entered into a post-hospitalization transition of care program (Discharge, Assessment, and Summary @ Home,DASH, Klingensmith HealthCare, Ford City, PA). The program consists of face to face visits by a respiratory therapist with the patient in the patientÂ’s home on days 2, 7, and 30 following hospital discharge. The visits are supplemented by a series of care coordinator phone interviews. Education, behavior modification, skills training, oxygen titration during performance of activities of daily living, clinical assessment, and adherence data collection are components of the program. The status of a scheduled patient-physician visit within the 30 day period was assessed. Each patient was asked at the day 2 visit about whether a visit was scheduled with the physician within the next month. The 30 day readmission rate for all patients was assessed. Results: 256 patients who required supplemental oxygen therapy completed the program over a twenty four month period (January 1, 2010 through December 30, 2011)(192 with COPD, 24 with CHF, 9 with pneumonia, and 15 with hypoxemia). 109/256 (41%) did not have a physician office visit scheduled within the month. Overall, 17/256 (6.6%) patients were readmitted within a 30 day period. 70 of 192 (36%) patients with a diagnosis of COPD did not have a visit scheduled. Of these, 9 (4.6%) were readmitted within 30 days. For those patients who were readmitted (n=17), 9 (52%) did not have an office visit scheduled. Conclusions: The DASH program resulted in a low number of rehospitalizations for patients with hypoxemia. A significant number of patients who ultimately required rehospitalization did not have a physician office visit scheduled for the first month following hospitalization. Sponsored Research - Study was conducted by Klingensmith HealthCare