The measure estimates a hospital-level 30-day, all-cause, risk-standardized readmission rate (RSRR) for patients age 65 and over discharged from the hospital with either a principal discharge diagnosis of COPD or a principal discharge diagnosis of respiratory failure with a secondary diagnosis of acute exacerbation of COPD. The outcome (readmission) is defined as unplanned readmission for any cause within 30 days of the discharge date for the index admission (the admission included in the measure cohort). A specified set of planned readmissions do not count in the readmission outcome. CMS annually reports the measure for patients who are 65 years or older and are enrolled in fee-for-service (FFS) Medicare and hospitalized in non-federal hospitals or are patients hospitalized in Veterans Health Administration (VA) facilities.
The outcome for this measure is 30-day readmission. We define readmission as an inpatient admission for any cause, with the exception of certain planned readmissions, within 30 days from the date of discharge from the index admission for patients discharged from the hospital with a principal discharge diagnosis of COPD or principal discharge diagnosis of respiratory failure with a secondary discharge diagnosis of acute exacerbation of COPD. If a patient has more than one unplanned admission (for any reason) within 30 days after discharge from the index admission, only the first one is counted as a readmission. The measure looks for a dichotomous yes or no outcome of whether each admitted patient has an unplanned readmission within 30 days. However, if the first readmission after discharge is considered planned, any subsequent unplanned readmission is not counted as an outcome for that index admission because the unplanned readmission could be related to care provided during the intervening planned readmission rather than during the index admission.
Denominator
1.15 Denominator
The cohort includes admissions for patients aged 65 or older, who have been discharged from the hospital with either a principal discharge diagnosis of COPD OR a principal discharge diagnosis of respiratory failure with a secondary discharge diagnosis of acute exacerbation of COPD and with a complete claims history for the 12 months prior to admission.
Additional details are provided in S.9 Denominator Details.
Exclusions
Exclusions
The 30-day COPD readmission measures exclude index admissions for patients:
1. Without at least 30 days post-discharge enrollment in FFS Medicare (in the case of patients who are not VA beneficiaries); 2. Discharged against medical advice (AMA); and, 3. Admitted within 30 days of a prior index admission for COPD.
Measure Record
Most Recent Endorsement Activity
Endorsed All-Cause Admissions and Readmissions Fall Cycle 2020
Public Comments