Mental Health Complicates Recovery from COPD, Study Finds

Research conducted at the University of Texas has identified an important role of psychological disorders in the early readmission of patients with chronic obstructive pulmonary disease (COPD).

COPD is estimated to affect 12 to 24 million individuals and is one of the leading causes of death in the United States. One in five patients with the condition need readmission within 30 days of their primary admission, which can be a huge burden on hospitals especially with the fines levied by CMS on this front.

The authors of the study, published in the journal Chest, analyzed data from fee-for-service Medicare beneficiaries with COPD over a 10-year period between 2001 and 2011 who were hospitalized with a primary discharge diagnosis of COPD or primary discharge diagnosis of respiratory failure with secondary diagnosis of COPD. The study hypothesis was that psychological disorders (depression, anxiety, psychosis, alcohol abuse, and drug abuse) are independently associated with an increased risk of 30-day readmission in patients with COPD.

During their study period, the authors documented 135,498 hospitalizations for COPD in over 80,000 fee-for-service Medicare enrollees. About 22% of these patients had 1 or more psychological disorders, and multivariate analysis identified 5% to 14% higher 30-day readmissions in these individuals compared with those who did not have these disorders. These patients also had a longer initial length of time in the hospital and a lower rate of outpatient follow-up visits within the first month after discharge.

According to study author Gurinder Singh, "These psychological disorders are more likely to predict early readmission than other significant factors. This is likely related to the limited ability of these patients to handle the COPD, poor social support or community resources and non-adherence with treatment. Because of the complexity of this situation, hospitals and healthcare providers need more guidance to reduce readmission in patients with COPD, and it may not be practical to penalize hospitals for higher early readmission rates. More studies are needed in this area."