Rates of hospital readmissions for COPD patients rise since 2008
Chronic obstructive pulmonary disease (COPD) patients are increasingly likely to be readmitted to hospital within three months of discharge, according to a national report.
The latest findings from the national COPD audit programme, published by the Royal College of Physicians on February 1, showed older COPD patients are more likely to be readmitted than younger ones.
The report said: ‘Many of the patients appeared to be on a continuous cycle of hospital admission, suggesting that the needs of this challenging group have received insufficient attention.’
The audit looked at outcomes for patients admitted to acute NHS units in England with COPD exacerbations from February to April 2014.
It found just under a quarter of patients (24%) were readmitted at least once, for any cause, within 30 days of discharge and nearly half (43%) were readmitted at least once within 90 days.
The latter marked a considerable increase from the 33% 90-day readmission rate in 2008.
Gloucestershire's Minchinhampton Surgery respiratory nurse specialist Carol Stonham said: ‘We have to think beyond the old divides if care is to be effective and sustainable for patients with COPD.’
University Hospitals of Leicester NHS Trust respiratory nurse consultant Jane Scullion said it was not always care failings which caused patients to be readmitted.
She said: ‘It might be that they are sick and they get to go home for a while. Instead of staying in hospital for two months as they die, they are getting home for periods of time.’
The report showed one third of patients under 55 years old had one or more all-cause readmissions within 90 days but this rose to 41% for 55 to 64 year olds and 46% for those over 75.
Re-admission within 90 days for all causes also rose in relation to the number of comorbidities patients had – from 33% of patients with no comorbidities to half of patients with four or more conditions.
The researchers said the reasons for high admission and readmission rates could include poor coordination between primary and secondary care services and lack of social care.
Recommendations included a review by a suitable primary care clinician of discharged patients happening within seven days of discharge.