The Hospital Readmissions Reduction Program (HRRP) was developed and implemented by the Centers for Medicare & Medicaid Services to curb the rate of 30-day hospital readmissions for certain common, high-impact conditions. In October 2014, COPD became a target condition for which hospitals were penalized for excess readmissions. The appropriateness, utility, and potential unintended consequences of the metric have been a topic of debate since it was first enacted. Nevertheless, there is evidence that hospital policies broadly implemented in response to the HRRP may have been responsible for reducing the rate of readmissions following COPD hospitalizations even before it was added as a target condition. Since the addition of the COPD condition to the HRRP, several predictive models have been developed to predict COPD survival and readmissions, with the intention of identifying modifiable risk factors. A number of interventions have also been studied, with mixed results. Bundled care interventions using the electronic health record and patient education interventions for inhaler education have been shown to reduce readmissions, whereas pulmonary rehabilitation, follow-up visits, and self-management programs have not been consistently shown to do the same. Through this program, COPD has become recognized as a public health priority. However, 5 years after COPD became a target condition for HRRP, there continues to be no single intervention that reliably prevents readmissions in this patient population. Further research is needed to understand the long-term effects of the policy, the role of competing risks in measuring quality, the optimal postdischarge care for patients with COPD, and the integrated use of predictive modeling and advanced technologies to prevent COPD readmissions.
JAMA. 2019 Oct 8;322(14):1371-1380
[PMID:
31593271]
Tanaffos. 2016;15(2):75-82
[PMID:
27904538]
JAMA. 2011 Oct 26;306(16):1796-7
[PMID:
22028356]
Respirology. 2009 Mar;14(2):230-8
[PMID:
19272084]
N Engl J Med. 2013 Mar 28;368(13):1175-7
[PMID:
23465069]
JAMA. 2013 Jan 23;309(4):342-3
[PMID:
23340629]
Ann Intern Med. 2006 Jun 20;144(12):894-903
[PMID:
16785478]
Chest. 2015 May;147(5):1227-1234
[PMID:
25940250]
Curr Opin Pulm Med. 2018 Mar;24(2):138-146
[PMID:
29210750]
J Pain Palliat Care Pharmacother. 2008;22(4):306-11
[PMID:
21923316]
Int J Chron Obstruct Pulmon Dis. 2007;2(3):241-51
[PMID:
18229562]
JAMA. 2011 Feb 16;305(7):675-81
[PMID:
21325183]
Respir Med. 2007 Jul;101(7):1462-9
[PMID:
17339106]
Hosp Pharm. 2017 Apr;52(4):264-265
[PMID:
28515504]
Med Care. 2018 Aug;56(8):673-678
[PMID:
29912841]
JAMA Netw Open. 2018 Nov 2;1(7):e184154
[PMID:
30646342]
Respir Med. 2015 Feb;109(2):238-46
[PMID:
25559374]
CMAJ. 2010 Apr 6;182(6):551-7
[PMID:
20194559]
Chest. 2015 May;147(5):1219-1226
[PMID:
25539483]
JAMA Intern Med. 2019 Jun 1;179(6):769-776
[PMID:
30985863]
Ann Am Thorac Soc. 2019 Feb;16(2):161-170
[PMID:
30707066]
Chest. 2012 Jan;141(1):87-93
[PMID:
21757568]
Chest. 2015 Apr;147(4):989-998
[PMID:
25375955]
Int J Chron Obstruct Pulmon Dis. 2016 Mar 17;11:577-83
[PMID:
27042046]
BMJ Qual Saf. 2017 Nov;26(11):908-918
[PMID:
28733370]
Med Care. 2017 Jul;55 Suppl 7 Suppl 1:S20-S25
[PMID:
28288076]
Chest. 2017 Feb;151(2):366-373
[PMID:
27746201]
J Hosp Med. 2020 Feb 11;15(4):252-253
[PMID:
32118570]
Ther Adv Respir Dis. 2017 Oct;11(10):383-392
[PMID:
28849736]
Risk Manag Healthc Policy. 2014 May 28;7:105-12
[PMID:
24971039]
Ann Am Thorac Soc. 2018 Jul;15(7):801-803
[PMID:
29957037]
Am J Manag Care. 2017 Aug 1;23(8):e253-e258
[PMID:
29087152]
Am J Respir Crit Care Med. 2014 Mar 15;189(6):634-9
[PMID:
24460431]
Ann Intern Med. 2015 Sep 15;163(6):427-36
[PMID:
26343790]
J Gen Intern Med. 2013 May;28(5):652-9
[PMID:
23225255]
BMC Pulm Med. 2011 Nov 04;11:49
[PMID:
22054636]
Am J Emerg Med. 2018 Sep;36(9):1650-1654
[PMID:
29970272]
Health Aff (Millwood). 2018 Apr;37(4):654-661
[PMID:
29608366]
Int J Chron Obstruct Pulmon Dis. 2016 Jun 02;11:1161-9
[PMID:
27330284]
Issue Brief (Commonw Fund). 2012 Dec;34:1-16
[PMID:
23289161]
Chest. 2000 Feb;117(2 Suppl):5S-9S
[PMID:
10673466]
Chest. 2016 Oct;150(4):916-926
[PMID:
27167208]
CMAJ. 2011 Apr 19;183(7):E391-402
[PMID:
21444623]
Ann Am Thorac Soc. 2016 Jun;13(6):816-24
[PMID:
26998961]
JAMA Intern Med. 2013 Apr 22;173(8):632-8
[PMID:
23529115]
Ann Am Thorac Soc. 2017 May;14(5):643-648
[PMID:
28005410]
Thorax. 2017 Aug;72(8):686-693
[PMID:
28235886]
N Engl J Med. 2012 Apr 12;366(15):1366-9
[PMID:
22455752]
Ann Am Thorac Soc. 2013 Dec;10(6):680-4
[PMID:
24364772]
JAMA. 2018 Dec 25;320(24):2542-2552
[PMID:
30575880]
IEEE J Biomed Health Inform. 2018 Mar;22(2):588-596
[PMID:
28328520]
Med Care. 2017 Mar;55(3):285-290
[PMID:
27755392]
Thorax. 2010 May;65(5):423-8
[PMID:
20435864]
Ann Am Thorac Soc. 2014 Oct;11(8):1203-9
[PMID:
25167366]
Chest. 2019 Oct;156(4):802-807
[PMID:
31590710]
Chronic Obstr Pulm Dis. 2019 Apr 9;6(2):129-131
[PMID:
30974052]
Am J Respir Crit Care Med. 2021 Feb 15;203(4):437-446
[PMID:
32871097]
Ann Am Thorac Soc. 2020 Apr;17(4):450-456
[PMID:
31860333]
Ann Am Thorac Soc. 2020 Apr;17(4):423-425
[PMID:
32233856]
J Hosp Med. 2013 Feb;8(2):102-9
[PMID:
23184714]
N Engl J Med. 2009 Apr 2;360(14):1418-28
[PMID:
19339721]
Chest. 2006 Dec;130(6):1844-50
[PMID:
17167007]
Am J Respir Crit Care Med. 2018 Nov 1;198(9):1130-1139
[PMID:
29979608]
Chest. 2020 Mar;157(3):481-483
[PMID:
32145799]
JAMA. 2017 Nov 7;318(17):1702-1703
[PMID:
29114819]
Eur Respir Rev. 2020 Mar 20;29(155):
[PMID:
32198215]
Ann Intern Med. 2020 Jan 21;172(2):77-85
[PMID:
31842232]
Ann Am Thorac Soc. 2014 Mar;11(3):417-24
[PMID:
24423379]
COPD. 2010 Jun;7(3):164-71
[PMID:
20486814]
Health Aff (Millwood). 2016 Jan;35(1):124-31
[PMID:
26733710]
Thorax. 2012 Feb;67(2):117-21
[PMID:
21896712]
