Modeling and Analysis of Postdischarge Intervention Process to Reduce COPD Readmissions

This paper is devoted to modeling and analysis of intervention process to reduce hospital readmissions of patients with chronic obstructive pulmonary disease (COPD). As compliance is a major issue among COPD patients, and economic burden and social support can be important factors affecting compliance and readmission, we propose to hospital management to reimburse out-of-pocket and transportation costs for COPD patients visiting primary care physicians and rehab centers, which are used as incentives to encourage them complying with patient-specific intervention plan. Then, we introduce an optimization model to minimize COPD readmission rate under incentive budget constraint and patients' readmission risks. Solving the problem, the minimal readmission rates are evaluated and the conditions to achieve the optimal solution are derived, which can provide a guideline for hospital management to plan appropriate incentive budget and benchmark the desired readmission rate. A case study at a community hospital is presented to illustrate the method. Finally, cost-effective analysis, sensitivity studies, and implementation discussions are carried out.