Key result
Only ~24% of surveyed physicians routinely use structured COPD discharge summaries despite high adoption willingness.
Why the study?
What are the physician-reported discharge practices, perceived gaps, and organizational barriers following COPD exacerbations?
What are the physician-reported discharge practices, perceived gaps, and organizational barriers following COPD exacerbations?
There are significant gaps between recommended and routine COPD discharge practices, with major organizational barriers to implementing structured discharge summaries despite high physician willingness.
Low routine use of structured discharge summaries highlights implementation gaps after COPD exacerbation; leaves open whether addressing barriers improves adoption and outcomes.
Background/Objectives: Discharging patients after hospitalization for an acute exacerbation of chronic obstructive pulmonary disease (COPD) is a critical transition in care associated with a high risk of early readmission. This survey aimed to describe physician-reported discharge practices following COPD exacerbations, identify perceived gaps and organizational barriers, explore attitudes toward structured COPD discharge summaries, and use a SWOT analysis as an interpretative framework. Methods: In this cross-sectional observational survey, 100 physicians involved in COPD care were recruited from the official mailing list of the Respiratory Society of Serbia, which represents approximately 71% of the Society’s members. The survey assessed discharge procedures, multidisciplinary practices, patient education, comorbidity management, perceived causes of readmission, and barriers to structured discharge summaries. Data were analyzed descriptively and complemented with a structured SWOT (Strengths, Weaknesses, Opportunities, Threats) analysis. Results: Most respondents worked in tertiary care settings and were involved in managing patients hospitalized for COPD exacerbations. Although 24% of physicians routinely used structured discharge summaries, 45% reported never using them. The most frequently perceived contributors to 30-day readmissions were active smoking (90%), poor treatment adherence (81%), comorbidities (77%), and incorrect inhaler technique (72%). Major barriers to implementing structured discharge summaries included the lack of standardized templates, time constraints, poor coordination across healthcare levels, and technical limitations. Willingness to implement structured discharge tools was high (mean score 8.86/10). SWOT analysis identified strong professional support for discharge standardization alongside organizational and system-level barriers to implementation. Conclusions: This exploratory survey identified important gaps between recommended and routine COPD discharge practices and highlighted organizational barriers to implementation. The findings may inform future evaluation and development of structured discharge tools in this healthcare setting.
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Dimić-Janjić et al. (2026) studied this question. Structured discharge summaries for COPD exacerbations are routinely used by only 24% of surveyed physicians, with 45% never using them, despite high willingness (8.86/10) to adopt them.
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