The effect of home respiratory therapy on hospital readmission rates of patients with chronic obstructive pulmonary disease.

The South Hills Health System Home Health Agency, Homestead, Pennsylvania, studied the effect of home respiratory therapy on hospital readmission rates in 418 patients with chronic obstructive pulmonary disease (COPD). Respiratory therapists evaluated and followed referred patients in their homes. Oxygen, breathing equipment, and supplies were provided, and patients were educated in use, cleaning, and maintenance of equipment. Data for the study were taken from hospital records, home assessments, and discharge summaries. All patients studied had been hospitalized in the year prior to receiving home respiratory therapy. After 12 months of follow-up, 64% had not been rehospitalized. In the year prior to home respiratory therapy, the average number of hospital admissions per patient had been 1.28, with the average length of hospital stay being 18.25 days. During the home respiratory therapy study period of 12 months, the average number of hospital admissions was 0.48, with the average length of hospital stay being 6.09 days. These results indicate that home care provided by respiratory therapists can significantly reduce the rehospitalization of COPD patients. Prevention of rehospitalization in the study group resulted in estimated average hospital costs of savings of $2,625 per per patient for the year. As a result of this study, two large local industrial employers, the Federal Black Lung program, and Blue Cross of Western Pennsylvania have added respiratory therapy to their home health benefits.