An integrated care intervention (ICI) reduces readmissions after a hospitalization for acute exacerbation of COPD

Introduction: Early readmission following a hospitalization for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a relevant clinical problem. Aim: We examined how a local ICI for COPD influences readmissions following an index hospital admission for AECOPD compared with a control group on usual care. Methods: An observational, electronic health record based, cohort study was used to evaluate AECOPD admissions between 1/1/2016 to 31/12/2017 in a city hospital. The primary outcome measure was the total number of readmissions in 30- and 90-day postindex hospitalizations comparing ICI (n=77) versus usual care (n=225 patients). Secondary outcome measures included the length of time between the index admission and first all-cause readmission. Results: The two groups were similar in terms of age, sex and number and types of comorbidities. ICI significantly reduced 30-days (mean number 0.05 vs 0.13, p=0.02) and 90-day (mean number 0.24 vs 0.52, p=0.001) all-cause readmission compared with control group on usual care. The average times between index admission and first readmission were lower in the standard care vs ICI group ( 102±84 vs 228±175 days, p=0.001). ICI also reduced AECOPD specific readmissions within 30 and 90 days. Conclusions: Patients in the ICI admitted for AECOPD had a significant lower hospitalizations for all-cause readmission and AECOPD specific readmission. This study reinforces the implementation of ICI for COPD to reduce rehospitalisation.