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Chronic Obstructive Pulmonary Disease Readmissions and Other Measures of Hospital Quality.

Chronic Obstructive Pulmonary Disease Readmissions and Other Measures of Hospital Quality.
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Rinne ST, Castaneda J, Lindenauer PK, Cleary PD, Paz HL, Gomez JL,


Rinne ST, Castaneda J, Lindenauer PK, Cleary PD, Paz HL, Gomez JL, (click to view)

Rinne ST, Castaneda J, Lindenauer PK, Cleary PD, Paz HL, Gomez JL,

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American journal of respiratory and critical care medicine 2017 02 01() doi 10.1164/rccm.201609-1944OC
Abstract
BACKGROUND
The Centers for Medicare & Medicaid Services (CMS) recently implemented financial penalties to reduce hospital readmissions for select conditions, including chronic obstructive pulmonary disease (COPD). Despite growing pressure to reduce COPD readmissions, it is unclear how COPD readmission rates are related to other measures of quality. Understanding the association of COPD readmissions and other quality measures could help focus efforts on common organizational factors affecting high quality patient care.

METHODS
We analyzed data from the 2015 CMS annual files, downloaded from the Hospital Compare website. We included 3,705 hospitals nationwide that had publically reported data on COPD readmissions. We compared COPD readmission rates to other risk-adjusted measures of quality, including readmission and mortality rates for other conditions, and patient reports about care experiences.

RESULTS
There were modest correlations between COPD readmission rates and readmission rates for other medical conditions, including heart failure (R2 = 0.39, p < 0.01), acute myocardial infarction (R2 = 0.30, p < 0.01), pneumonia (R2 = 0.38, p < 0.01), and stroke (R2 = 0.29, p < 0.01). In contrast we found low correlations between COPD readmission rates and readmission rates for surgical conditions as well as mortality rates for all measured conditions. There were significant correlations between COPD readmission rates and all patient experience measures. CONCLUSIONS
These findings suggest there may be common organizational factors that influence multiple disease-specific outcomes. As pay-for-performance programs focus attention on individual disease outcomes, hospitals may benefit from in-depth assessments of organizational factors affecting multiple aspects of hospital quality.

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