The impact of patient education and shared decision making on hospital readmissions for COPD

Figures & data

Figure 1 Patient disposition.

Table 1 Baseline demographics and characteristics

Characteristics	Control group (n=167)	CCC group (n=141)	P-value
Age, mean (SD) (years)	70.9 (12.5)	70.0 (11.9)	0.533
Female, n (%)	95 (56.9)	85 (60.3)	0.547
Ethnicity, n (%)
Hispanic	9 (5.4)	6 (4.3)	0.645
Not hispanic	158 (94.6)	135 (95.7)
Smoking status, n (%)
Current smoker	50 (29.9)	47 (33.3)	0.079
Former smoker	75 (44.9)	57 (40.4)
Never smoked	26 (15.6)	32 (22.7)
PAM score, n (%)
1	42 (31.8)	38 (31.7)	0.564
2	57 (43.2)	46 (38.3)
3	32 (24.2)	36 (30.0)
4	1 (0.8)	0 (0.0)
GOLD category,* n (%)
1 (FEV1 ≥80% predicted)	2 (7.4)	3 (12.0)	0.441
2 (50%≤ FEV1 <80% predicted)	23 (85.2)	17 (68.0)
3 (30%≤ FEV1 <50% predicted)	2 (7.4)	4 (16.0)
4 (FEV1 <30% predicted)	0 (0.0)	1 (4.0)
CAT category, n (%)
Low (score of 0–9)	10 (7.6)	3 (2.5)	0.068
Medium (score of 10–19)	35 (26.7)	37 (30.8)
High (score of 20–29)	70 (53.4)	55 (45.8)
Very high (score of 30–40)	16 (12.2)	25 (20.8)
CAT score, mean	22.3	22.8	0.6981
Charlson Comorbidity Index, mean (SD)	5.45 (2.27)	5.29 (2.44)	0.559
BMI, mean (SD) (kg/m^2)	30.3 (13.8)	29.7 (9.5)	0.680
Previous hospital utilization**
Hospital visits, mean (SD)	1.6 (2.0)	1.2 (1.3)	0.044
ED visits, mean (SD)	1.9 (2.3)	1.4 (1.9)	0.077
Index admission LOS, mean (SD) (days)	5.9 (4.1)	5.6 (3.6)	0.536
Patients completing follow-up calls post-discharge, n (%)
3–7 days	NA	78 (55.3)
30 days	NA	62 (44.0)
60 days	NA	61 (43.2)
180 days	48 (28.7)	52 (36.9)

Notes:

* Most recent GOLD categorization during the 12 months prior to, or 2 weeks following, hospital admission.

** Self-reported in the 12 months prior to study enrollment.

Abbreviations: BMI, body mass index; CAT, COPD Assessment Test; CCC, COPD Chronic Care; ED, emergency department; GOLD, Global initiative for chronic Obstructive Lung Disease; LOS, length of stay; NA, not applicable; PAM, Patient Activation Measure; SD, standard deviation.

Table 2 All-cause and COPD-related readmissions at 6 months

Number of readmissions at 6 months	All-cause readmissions			COPD-related readmissions
	Control (n=167)	CCC group (n=141)	P-value	Control (n=167)	CCC group (n=141)	P-value
Inpatient, n (%)			0.242			0.099
0	106 (63.5)	72 (51.1)		154 (92.2)	119 (84.4)
1	35 (21.0)	41 (29.1)		11 (6.6)	20 (14.2)
2	17 (10.2)	18 (12.8)		2 (1.2)	1 (0.7)
≥3	9 (5.4)	10 (7.1)		0 (0.0)	1 (0.7)
ED, n (%)			0.477			0.424
0	117 (70.1)	103 (73.1)		160 (95.8)	132 (93.6)
1	25 (15.0)	19 (13.5)		6 (3.6)	8 (5.7)
2	13 (7.8)	13 (9.2)		0 (0.0)	1 (0.71)
≥3	12 (7.2)	6 (4.3)		1 (0.6)	0 (0.0)
Outpatient/short stay, n (%)			0.195			0.904
0	100 (59.9)	83 (58.9)		153 (91.6)	128 (90.8)
1	40 (24.0)	27 (19.2)		9 (5.4)	9 (6.4)
2	9 (5.4)	14 (9.9)		3 (1.8)	3 (2.1)
≥3	18 (10.8)	17 (11.3)		2 (1.2)	1 (0.7)
Total, n (%)			0.401			0.152
0	62 (37.1)	39 (27.7)		141 (84.4)	109 (77.3)
1	32 (19.2)	28 (19.9)		17 (10.2)	19 (13.5)
2	23 (13.8)	23 (16.3)		4 (2.4)	8 (5.7)
≥3	50 (30.0)	51 (36.2)		5 (3.0)	5 (3.5)

Abbreviations: CCC, COPD Chronic Care; ED, emergency department.

Figure 2 Time to all-cause readmission (inpatient, ED, or outpatient).

Notes: Outpatients: classified as patients with short stay or 24-hour observation and not admitted as inpatients. Cross mark indicates patient death.

Abbreviations: CCC, COPD Chronic Care; ED, emergency department.

Figure 3 Time to first COPD-related readmission (inpatient, ED, or outpatient).

Notes: Outpatients: classified as patients with short stay or 24-hour observation and not admitted as inpatients. Cross mark indicates patient death.
Abbreviations: CCC, COPD Chronic Care; ED, emergency department.