Chronic obstructive pulmonary disease (COPD) is a group of progressive chronic inflammatory lung conditions that cause breathing difficulties. The onset of COPD symptoms usually appears in patients during their 40s or 50s, including a chesty cough with phlegm, persistent wheezing, and frequent chest infections that worsen with time. Patients with COPD can experience worsening symptoms, and when this happens, they often require readmission to the hospital. COPD exacerbation is a vital healthcare issue because it contributes greatly to the disease burden in China. A recent study by Li and colleagues, published in October 2022 in Nature, found a significant increase in 30-day COPD-related readmissions over a six-year study period in Beijing, China. These study findings are important because the rate of 30-day COPD-related readmissions post-discharge is a good indicator of healthcare quality and defines the current state of care and management. These study findings are important in helping healthcare policymakers strengthen disease management in the future as COPD-readmissions remain high.
Li and colleagues described the trend in 30-day COPD-related readmission rates from 2012 to 2017 by analysing the citywide hospital discharge database of 74,152 COPD patients 40 years and older living in Beijing, China. They defined a 30-day COPD-related readmission as the initial admission with a primary diagnosis of COPD that occurs within 30 days from the discharge date of index admission. The index admission was described as hospitalisation with a primary diagnosis of COPD that did not result in death. The COPD-related readmission rate increased significantly from 11.5% in 2012 to 17.2% in 2017, resulting in an overall readmission rate of 15.8%. 20.1% of readmissions occurred on day one after index discharge, and 49.9% occurred within seven days after index discharge.
The study identified being male, hospitalisation for COPD in the previous year, admission to a tertiary hospital, mechanical ventilation, a hospital stay of longer than ten days, and comorbid osteoporosis, coronary heart disease, congestive heart failure, and cancer as risk factors of COPD-related readmission. These risk factors are all closely tied to the state of the patient’s health and existence in either a healthcare system or receiving treatment, which further prompts the need for improved healthcare quality.
Improving care quality plays a key role in reducing early COPD-related readmission rates; this is an essential preventative step as China faces a growing number of COPD patients. GlobalData epidemiologists estimate that just over 50 million men and women aged 35 years and above will be diagnosed and living with COPD in China by the end of 2022. This number is forecast to increase to 56 million by 2028 (Figure 1).
COPD-related readmission can be effectively slowed down by improving healthcare quality and reducing the risk factors associated with an increased chance of COPD readmission. This six-year trend analysis of 30-day COPD-related readmissions provides valuable epidemiological insight into COPD readmission rate trends and, consequently, the state of the current healthcare in China.