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How an integrated care pathway reduces COPD readmissions—and costs

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Authors and affiliations:

Rick Nicksic, Managing Partner; Greg Cooper, Managing Partner; Amy Day, RRT,   Senior VP, Clinical Services. IncreMedical, LLC, 8259 Wicker Avenue, St. John, IN 46373.


Overview of an abstract presented by abstract presented by by IncreMedical, LLC. Authors and affiliations:

Reducing readmissions, especially for complex COPD patients, is clearly a challenge, both clinically and economically.

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In 2014, COPD-related healthcare costs exceeded $36 billion.1

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In 2015, 78% of hospitals were penalized for readmission.1

What if there was a way to facilitate early, appropriate COPD diagnosis and provide continuous monitoring and intervention in the acute and post-acute care settings so that COPD hospital readmissions are reduced?

An integrated care pathway approach


The 18-month study sought to reduce readmissions by using an integrated care pathway method. The method comprised customized, evidence-based management protocols and clinical pathways, including transitional acute to post-acute multifaceted care management, care coordination, noninvasive ventilation (NIV), and oxygen and patient engagement strategies.


All-cause 30-day hospital readmission data for patients screened over a period of five months were analyzed.160 patients were identified with a primary or secondary diagnosis of COPD and were offered services provided under the integrated care pathway. Of the COPD patients, 36 elected to participate and were followed.

A 90-day period preceding the screening event and a 90-day period following were examined for hospital readmissions. All participating patients were prescribed oxygen therapy and noninvasive ventilators; nebulizers were prescribed for the majority.

Study results

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All-cause 30-day hospital readmissions declined from 30.6% to 13.9%. For comparison, the hospital-reported readmission rate for COPD patients was 19.6%. This observed decline in readmissions represents a savings of 55%.



Implementing a comprehensive COPD program that includes acute and post-acute care management reduced the need for hospital-based care in the patient population served in the program.

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