Patient-centered outcomes of recovery after hospitalizations for chronic obstructive pulmonary disease
Funded Grant
Overview
Overview
description
Project Summary Over 822,500 hospitalizations in the United States are annually attributed to exacerbations of chronic obstructive pulmonary disease (COPD), making them among the most common reasons for hospital admission. Patients often experience functional declines following such hospitalizations, requiring weeks to months of recovery. Some never regain their prior health status. Considerable research and policy making has sought to improve the value of care after discharge from a COPD hospitalization by targeting prevention of hospital readmissions, a primary outcome by which providers are assessed. Other studies have measured the value of interventions to improve recovery using presumably patient-centered outcomes such as quality of life measures, functional status, and avoidance of exacerbations and hospitalization. However, this work is limited because the outcomes of recovery most valued by patients remain unknown. This key knowledge gap in patient perspectives on recovery limits the design of interventions that improve the value to patients of post- COPD-exacerbation care. The goals of this study are to describe patient-centered outcomes and patient narratives of recovery after hospitalization for COPD exacerbations. First, using a retrospective cohort of Medicare beneficiaries admitted to hospitals with COPD exacerbations, I will describe attainment of patient-centered outcomes of recovery, specifically the number hospital-free days and facility-free days, and improvement in functional status. Second, I will identify how patients with COPD define recovery and value different elements of recovery through longitudinal semi-structured interviews with patients discharged from hospitalization for COPD exacerbation. Understanding of patient-centered outcomes will enhance our ability to develop and target interventions that align COPD care delivery with patient values. This project will also provide key preliminary data for my planned NIH K-Series Career Development Award that will further examine patient values and trajectories in recovery from COPD exacerbations using a longer-term prospective cohort of patients.
