Prompt Post-Discharge Follow-up with a Pulmonologist Reduces Rehospitalizations for Patients with COPD

Patients with chronic obstructive pulmonary disease (COPD) who do not follow-up with their pulmonologists after being discharged from the hospital face a significantly higher risk of being readmitted than those who do. Rachel Gavish, MD, and colleagues with the Departments of Public Health, Medicine, and Pulmonology at Ben-Gurion University of the Negev conducted a study to assess the impact a follow-up visit with a pulmonologist after discharge from the hospital had for patients with COPD. The study was published in Chest, in August 2015.

Although there have been several studies regarding why more half of the patients hospitalized due to COPD must be readmitted during the course of the first year after discharge, no one had examined the relationship between a follow-up visit with a pulmonologist during the first month after discharge and the rate of rehospitalization.

The researchers conducted a “population based retrospective cohort study using the data of patients who were treated at the lung institute in Soroka University Medical Center.” They looked specifically at patients who were hospitalized due to exacerbations of COPD over the course of six years. There were 195 patients who met the criteria.

Of the 195 patients considered in the study, 35 were readmitted within 90 days of being discharged. Of those, 77.1% did not attend a follow-up visit with a pulmonologist. There were several factors that may have attributed to the lack of a follow up visit, including distance, and no recommendation for a follow-up with a pulmonologist on the discharge letter.

Several factors were associated with a lower risk of rehospitalization including a pre-admission visit with a pulmonologist, a written recommendation for a follow-up visit with a pulmonologist, and living within 30 kilometers of the pulmonologist’s office.

Previous research showed the effectiveness of an “organized discharge plan in reducing readmission.” This study shows that including a written recommendation for a follow-up visit with a pulmonologist when patients with COPD are discharged from the hospital is important.