Key result
Older age is linked to ~59% greater 30-day COPD readmission risk, alongside hospital and insurance factors.
Why the study?
High readmission rates in COPD have driven proactive mitigation measures, prompting the identification of risk factors and vulnerable groups requiring transitional care services tailored to Korea.
Cohort (n=4,874)
Odds Ratio: 1.59 (95% CI 1.19–2.12)
Absolute Event Rate: 28.7% vs 20.4%
p-value: p=<0.001
Older age, smaller hospital size, and provincial hospital location are significant risk factors for 30-day readmission in patients with COPD, highlighting populations that may benefit from targeted transitional care.
Identifies high-risk COPD subgroups for readmission; hypothesis-generating and should not yet change practice.
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.
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Hwang et al. (2023) conducted a cohort in Chronic Obstructive Pulmonary Disease (n=4,874). Older age (80s) vs. Younger age (50s) was evaluated on 30-day all-cause readmission (OR 1.59, 95% CI 1.19-2.12, p=<0.001). Older age (OR 1.59 for 80s vs 50s), local subscriber insurance, smaller hospital size, and provincial hospital location were significantly associated with an increased risk of 30-day readmission in patients with COPD.
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