Research Article| Volume 58, P69-73, March 2023

Association between inpatient palliative care encounter and 30-day all-cause readmissions after index hospitalization for chronic obstructive pulmonary disease

Published:November 18, 2022DOI:


      • Inpatient PCE is underutilized among COPD hospitalizations.
      • The inpatient PCE is inversely associated with the risk of 30-day all-cause rehospitalization.
      • This association varied by discharge destination and was statistically significant among those discharged to a facility (63%) and also among those discharged to home with home health (58%).
      • The potential for a decreased burden of rehospitalization along with its current underutilization suggests that there may be opportunities to improve patient outcomes by the incorporation of inpatient PCE in the care of the hospitalized COPD patient.



      Studies exist on the association between inpatient Palliative Care Encounter (iPCE) and 30-day rehospitalization among cancer and several non-cancer conditions but limited in persons with Chronic Obstructive Pulmonary Disease (COPD).


      To assess the association between an iPCE with the risk of 30-day rehospitalization after an index hospitalization for COPD.


      We conducted a cross-sectional analysis of the Nationwide Readmissions Database (2010–2014). Index hospitalizations were defined as persons ≥ 18 years of age, discharge destinations of either Home/Routine, Home with Home Care, or a Facility, and an index hospitalization with Diagnosis Related Group of COPD. The International Classification of Diseases, 9th revision codes were used to extract comorbidities and a Palliative Care Encounter (V66.7).


      There were 3,163,889 index hospitalizations and iPCE occurred in 21,330 (0.67%). There were 558,059 (17.63%) with a 30-day rehospitalization. An iPCE was associated with a significantly lower adjusted odds of 30-day readmission (Odds Ratio [OR], 0.50; 95% Confidence Interval [CI], 0.46 to 0.54).  By discharge destination, the odds of 30-day rehospitalization were for a discharged to a facility (OR, 0.37; 95% CI, 0.32 to 0.42), to home with home health (OR, 0.42; 95% CI, 0.37 to 0.47), and to home (OR, 0.98; 95% CI, 0.85 to 1.12) for those with relative to without iPCE.


      Inpatient PCE was associated with a 50% lower relative odds of 30-day rehospitalization after an index hospitalization for COPD. This association varied by discharge destination being statistically significant among those with a discharge destination of a facility (63%) and home with home care (58%).
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