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COPD affects nearly 16 million (6.4%) Americans.1 Many adults (50%) with poor pulmonary function are not aware they have COPD, likely increasing the number of individuals affected with the disease.2 COPD exacerbations result in roughly 700,000 hospitalizations and 1.5 million emergency department visits annually and is the third leading cause of death in the United States.3-5 Complications from COPD include activity limitations, poor quality of life, need for home care equipment, increased memory loss, clinical depression, and poor health status.6
Despite health care providers and health systems efforts to broadly follow the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines, the economic burden of COPD remains around $50 billion in direct and indirect costs.7 Approximately one in 5 COPD hospitalizations have a 30-day readmission with an estimated annual health care cost of $15 billion.8,9 The most frequent reasons for 30-day readmissions for COPD are age, socioeconomic status, poor device technique, and comorbidities affecting COPD.10
In 2015, the Centers for Medicare and Medicaid Services implemented a performance measure as a financial incentive for hospitals and health systems to evaluate the spectrum of care for patients with COPD. The intent of this incentive was for hospitals to incorporate different care models that would decrease 30-day readmissions.11 This performance measure has forced health care providers and health systems to eva-luate current processes and be innovative in creating new approaches to health care. One of those innovative approaches is …
Correspondence: Joyce A Baker MBA RRT RRT-NPS AE-C FAARC, Breathing Institute, Children’s Hospital Colorado, 13123 E 16th Avenue, Aurora, Colorado, 80045. E-mail: joyce.baker{at}childrenscolorado.org
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