Question
What respiratory conditions are major drivers of 30-day hospital readmissions?
Answer
DRG stands for Diagnosis-Related Group. It is a system used to classify hospital cases into groups based on similar clinical conditions and procedures. This classification helps determine the amount of reimbursement that hospitals receive for treating patients. Each DRG has a specific payment rate associated with it, and it is used in various healthcare systems worldwide as a way to standardize payments and manage healthcare costs. Of the top 20 most common diagnosis-related groups (MS-DRGs) discharged from hospital to homecare, 4 are respiratory, and for the most common readmit diagnoses, 3 are pulmonary conditions. Respiratory conditions are major drivers of 30-day hospital readmissions. Analysis shows three pulmonary diagnoses—simple pneumonia, pulmonary edema, respiratory failure, and respiratory infections and inflammations—are among the top 20 reasons for early unplanned return visits. Further, COPD flare-ups also contribute significantly to readmission rates.
Of particular concern, pulmonary edema and respiratory failure account for over 22% of all-cause 30-day readmits, while respiratory infections and inflammations with major complications or comorbidity make up another 15%. Comparatively, simple pneumonia and pleurisy with major complications or comorbidity drive roughly 19%. Still, pulmonary edema with hypoxemic respiratory failure follows closely behind.
This readmission prevalence indicates respiratory therapists have pivotal opportunities to reduce recurrence through acute and post-discharge intervention. Inpatient treatment optimization, patient and family education, discharge protocol enhancements, and transitional support coordination can better equip high-risk patients to sustain lung health outpatient.
Goal-directed respiratory therapy across the care continuum can target at-risk populations with multiple touchpoints - addressing both acute incidents and long-term disease self-management. Developing this discharge-to-home bridge is crucial for mitigating avoidable readmissions related to preventable pulmonary complications.
This Ask the Expert is an edited excerpt from the course, Subacute Care Discharge Planning for the Respiratory Patient, presented by Vrati Doshi, MSc, RRT.
