Chronic Obstructive Pulmonary Disease Outcomes at Veterans Affairs Versus Non-Veterans Affairs Hospitals

Abstract

Plain language summary: The U.S. Centers for Medicare and Medicaid Services (CMS) and the Veterans Health Administration have both implemented policies intended to reduce readmissions in patients with COPD, but little is known about the relative performance of VA and non-VA hospitals on COPD readmissions and mortality in the ensuing years. Clinical trials of various interventions designed to reduce hospital readmissions in patients with COPD have demonstrated the potential to reduce readmissions but also to increase the risk of death. This study compared readmission and death rates at VA and non-VA hospitals using publicly available data from CMS Hospital Compare. We also measured the association between hospital-level readmission and death rates at VA and non-VA hospitals and across various hospital characteristics. From 2015 to 2018, VA hospitals had lower COPD readmission and death rates compared to non-VA hospitals. Readmission and death rates were not associated at VA hospitals. Among non-VA hospitals, higher readmission rates were associated with lower death rates. The inverse association between readmission and death rates at non-VA hospitals calls for re-examination of readmissions policies