THURSDAY, Sept. 24, 2020 — For patients with chronic obstructive pulmonary disease (COPD), implementation of the Hospital Readmissions Reduction Program (HRRP) is associated with a reduction in 30-day readmissions but may increase mortality, according to a study published online Sept. 1 in the American Journal of Respiratory and Critical Care Medicine.

Daniel A. Puebla Neira, M.D., from the University of Texas Medical Branch at Galveston, and colleagues examined the association between HRRP and 30-day hospital readmission and 30-day postdischarge mortality among 4,587,542 Medicare fee-for-service beneficiaries with COPD aged 65 years and older. Data were analyzed for three periods: preannouncement of HRRP (December 2006 to March 2010), announcement (April 2010 to August 2014), and implementation (October 2014 to November 2017).

The researchers found that from the preannouncement period to the implementation period, there was a decrease in 30-day readmissions from 20.54 to 18.74 percent. For the preannouncement, announcement, and implementation periods, the 30-day risk-standardized postdischarge mortality rates were 6.91, 6.59, and 7.30 percent, respectively. An additional 1,196 and 3,858 deaths were estimated during the HRRP implementation period in equations analyses (October 2014 to April 2016 and May 2016 to November 2017, respectively).

“Further research is needed to confirm our findings and identify factors contributing to the increased mortality seen in patients with COPD in the Centers for Medicare & Medicaid Services readmission reduction program,” Puebla Neira said in a statement.

One author disclosed financial ties to the pharmaceutical industry.

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