Abstract
Patients with both COPD and heart failure (HF) pose particularly high costs to the health-care system. These diseases arise from similar root causes, have overlapping symptoms, and share similar clinical courses. Because of these strong parallels, strategies to reduce readmissions in patients with both conditions share synergies. Here we present 10 practical tips to reduce readmissions in this challenging population: (1) diagnose the population accurately, (2) detect admissions for exacerbations early and consider risk stratification, (3) use specialist management in hospital, (4) modify the underlying disease substrate, (5) apply and intensify evidence-based therapies, (6) activate the patient and develop critical health behaviors, (7) setup feedback loops, (8) arrange an early follow-up appointment prior to discharge, (9) consider and address other comorbidities, and (10) consider ancillary support services at home. The multidisciplinary care teams needed to support these care models pose expense to the health-care system. Although these costs may more easily be recouped under financial models such as accountable care organizations and bundled payments, the opportunity cost of an admission for COPD or HF may represent an underrecognized financial lever.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1230-1238 |
| Number of pages | 9 |
| Journal | CHEST |
| Volume | 154 |
| Issue number | 5 |
| DOIs | |
| State | Published - Nov 2018 |
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Keywords
- COPD
- heart failure
- readmissions
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
- Critical Care and Intensive Care Medicine
- Cardiology and Cardiovascular Medicine
Cite this
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Reducing Readmissions in Patients With Both Heart Failure and COPD. / Kalhan, Ravi; Mutharasan, Raja Kannan.
In: CHEST, Vol. 154, No. 5, 11.2018, p. 1230-1238.Research output: Contribution to journal › Review article
TY - JOUR
T1 - Reducing Readmissions in Patients With Both Heart Failure and COPD
AU - Kalhan, Ravi
AU - Mutharasan, Raja Kannan
PY - 2018/11
Y1 - 2018/11
N2 - Patients with both COPD and heart failure (HF) pose particularly high costs to the health-care system. These diseases arise from similar root causes, have overlapping symptoms, and share similar clinical courses. Because of these strong parallels, strategies to reduce readmissions in patients with both conditions share synergies. Here we present 10 practical tips to reduce readmissions in this challenging population: (1) diagnose the population accurately, (2) detect admissions for exacerbations early and consider risk stratification, (3) use specialist management in hospital, (4) modify the underlying disease substrate, (5) apply and intensify evidence-based therapies, (6) activate the patient and develop critical health behaviors, (7) setup feedback loops, (8) arrange an early follow-up appointment prior to discharge, (9) consider and address other comorbidities, and (10) consider ancillary support services at home. The multidisciplinary care teams needed to support these care models pose expense to the health-care system. Although these costs may more easily be recouped under financial models such as accountable care organizations and bundled payments, the opportunity cost of an admission for COPD or HF may represent an underrecognized financial lever.
AB - Patients with both COPD and heart failure (HF) pose particularly high costs to the health-care system. These diseases arise from similar root causes, have overlapping symptoms, and share similar clinical courses. Because of these strong parallels, strategies to reduce readmissions in patients with both conditions share synergies. Here we present 10 practical tips to reduce readmissions in this challenging population: (1) diagnose the population accurately, (2) detect admissions for exacerbations early and consider risk stratification, (3) use specialist management in hospital, (4) modify the underlying disease substrate, (5) apply and intensify evidence-based therapies, (6) activate the patient and develop critical health behaviors, (7) setup feedback loops, (8) arrange an early follow-up appointment prior to discharge, (9) consider and address other comorbidities, and (10) consider ancillary support services at home. The multidisciplinary care teams needed to support these care models pose expense to the health-care system. Although these costs may more easily be recouped under financial models such as accountable care organizations and bundled payments, the opportunity cost of an admission for COPD or HF may represent an underrecognized financial lever.
KW - COPD
KW - heart failure
KW - readmissions
UR - http://www.scopus.com/inward/record.url?scp=85052811305&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85052811305&partnerID=8YFLogxK
U2 - 10.1016/j.chest.2018.06.001
DO - 10.1016/j.chest.2018.06.001
M3 - Review article
C2 - 29908152
AN - SCOPUS:85052811305
VL - 154
SP - 1230
EP - 1238
JO - Chest
JF - Chest
SN - 0012-3692
IS - 5
ER -