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  • Measure Summary
  • NQMC:008301
  • Jan 2013

Chronic obstructive pulmonary disease (COPD): proportion of patients readmitted for acute exacerbation of COPD within 30 days of discharge.

Indicators in the Danish registry for chronic obstructive pulmonary disease (DrCOPD). Aarhus (DK): Competence Centre for Clinical Quality and Health Informatics West; 2013 Jan 2. 7 p.

This is the current release of the measure.

The measure developer reaffirmed the currency of this measure in October 2015.

Primary Measure Domain

Related Health Care Delivery Measures: Use of Services

Secondary Measure Domain

Clinical Quality Measure: Outcome

Description

This measure is used to assess the proportion of patients readmitted for acute exacerbation of chronic obstructive pulmonary disease (COPD) within 30 days of discharge.

Rationale

Hospitalization for chronic obstructive pulmonary disease (COPD)-exacerbation is associated with a high risk of readmission within the subsequent months. Prior Danish population-based data from 2001 and 2007 show that 14% of patients discharged alive were readmitted within a month. Readmission is a highly relevant outcome measure from the patient perspective as well as that of society as an indication of the total treatment effort during admission and the subsequent follow-up.

Evidence for Rationale

Indicators in the Danish registry for chronic obstructive pulmonary disease (DrCOPD). Aarhus (DK): Competence Centre for Clinical Quality and Health Informatics West; 2013 Jan 2. 7 p.

Primary Health Components

Acute exacerbation of chronic obstructive pulmonary disease (COPD); readmission

Denominator Description

Patients aged 30 years and older who were admitted for acute exacerbation of chronic obstructive pulmonary disease (COPD) with the following diagnoses according to the Danish version of the International Classification of Diseases, Tenth Revision (ICD-10):

  • J44.X as primary diagnosis

OR

  • J96.X or J13.X - J18.X as primary diagnosis in combination with J44.X as a secondary diagnosis

AND

  • Who are discharged alive

See the related "Denominator Inclusions/Exclusions" field.

Numerator Description

Patients readmitted for acute exacerbation of chronic obstructive pulmonary disease (COPD) within 30 days of discharge (see the related "Numerator Inclusions/Exclusions" field)

Type of Evidence Supporting the Criterion of Quality for the Measure

  • A formal consensus procedure, involving experts in relevant clinical, methodological, public health and organizational sciences

Additional Information Supporting Need for the Measure

Unspecified

Extent of Measure Testing

Unspecified

State of Use

Current routine use

Current Use

Accreditation

Collaborative inter-organizational quality improvement

Decision-making by consumers about health plan/provider choice

Decision-making by managers about resource allocation

External oversight/Regional, county, or city agencies

External oversight/State government program

Monitoring and planning

National reporting

Public reporting

Quality of care research

Measurement Setting

Hospital Inpatient

Professionals Involved in Delivery of Health Services

Physicians

Least Aggregated Level of Services Delivery Addressed

Single Health Care Delivery or Public Health Organizations

Statement of Acceptable Minimum Sample Size

Unspecified

Target Population Age

Age greater than or equal to 30 years

Target Population Gender

Either male or female

IOM Care Need

Not within an IOM Care Need

IOM Domain

Not within an IOM Domain

Case Finding Period

Unspecified

Denominator Sampling Frame

Patients associated with provider

Denominator (Index) Event or Characteristic

Clinical Condition

Institutionalization

Patient/Individual (Consumer) Characteristic

Denominator Time Window

Does not apply to this measure

Denominator Inclusions/Exclusions

Inclusions
Patients aged 30 years and older who were admitted for acute exacerbation of chronic obstructive pulmonary disease (COPD) with the following diagnoses according to the Danish version of the International Classification of Diseases, Tenth Revision (ICD-10):

  • J44.X as primary diagnosis

OR

  • J96.X or J13.X - J18.X as primary diagnosis in combination with J44.X as a secondary diagnosis

AND

  • Who are discharged alive

Note: Based on information related to civil registration numbers with an "inpatient course" including an acute admission for exacerbation in COPD in the Danish National Patient Registry (DNPR). An inpatient course is linked to the registration period through the discharge date.

Exclusions

  • Patients who only have a surrogate/temporary personal identifier = Danish civil registration number
  • Patients with "inactive" status in the Danish Civil Register: status = 20, 30, 50, 60, 70, 80
  • Patients who are included in the study population within the last 30 days
  • Patients with a vital status = 90 in the DNPR no later than the day of discharge

Exclusions/Exceptions

Does not apply to this measure

Numerator Inclusions/Exclusions

Inclusions
Patients readmitted for acute exacerbation of chronic obstructive pulmonary disease (COPD) within 30 days of discharge*

*Patients with a new admission date registered between 2 and 30 after being discharged alive

Exclusions
Unspecified

Numerator Search Strategy

Institutionalization

Data Source

Administrative clinical data

Paper medical record

Registry data

Type of Health State

Adverse Health State

Instruments Used and/or Associated with the Measure

Unspecified

Measure Specifies Disaggregation

Does not apply to this measure

Scoring

Rate/Proportion

Interpretation of Score

Does not apply to this measure (i.e., there is no pre-defined preference for the measure score)

Allowance for Patient or Population Factors

Unspecified

Standard of Comparison

External comparison at a point in, or interval of, time

Internal time comparison

Original Title

Proportion of patients readmitted for acute exacerbation of COPD within 30 days of discharge.

Measure Collection Name

The Danish Clinical Registers

Measure Set Name

Clinical Indicators for the Danish registry for Chronic Obstructive Pulmonary Disease (DrCOPD)

Submitter

The Danish registry for Chronic Obstructive Pulmonary Disease - National Government Agency [Non-U.S.]

Developer

Competence Centre for Clinical Quality and Health Informatics West - International Agency

The Danish registry for Chronic Obstructive Pulmonary Disease - National Government Agency [Non-U.S.]

Funding Source(s)

Danish Regions

Composition of the Group that Developed the Measure

The steering committee for The Danish registry for Chronic Pulmonary Obstructive Disease (DrCOPD)

  • Peter Lange, professor, consultant in respiratory medicine, DMSc, Section of Social Medicine, Department of Public Health, University of Copenhagen (chairperson); Danish Society of Respiratory Medicine
  • Anne Sorknæs, research nurse, MSc in Nursing, PhD student, The Pulmonary Ambulatory Clinic, The Hospital of Funen, Svendborg (chairperson); Danish Society for Pulmonary Medicine/Allergy Nurses
  • Jørgen Steen Andersen, general practitioner, Skovlunde (chairperson); The Danish College of General Practitioners
  • Tina Brandt Sørensen, consultant, the Regional Hospital in Horsens; Danish Society of Respiratory Medicine
  • Steffen Kristensen, consultant, head of The Medical Department, the Regional Hospital in Vejle; Danish Society of Respiratory Medicine
  • Jette Elbrønd, general practitioner, Rønnede; The Danish Medical Society
  • Ejvind Frausing Hansen, consultant, head of The Department of Pulmonary Medicine, Hvidovre Hospital (documentalist); Danish Society of Respiratory Medicine
  • Carl Nielsen, lead consultant, Department of Pulmonary Medicine, Aalborg Hospital; Danish Society of Respiratory Medicine
  • Annette Overgaard, respiratory nurse, The COPD team, The Pulmonary Ambulatory Clinic, the Regional Hospital of Viborg, Skive, Silkeborg and Hammel; Danish Society for Pulmonary Medicine/Allergy Nurses
  • Tove Nini Olsen, physiotherapist, Department of Rheumatology, Køge Hospital; Association of Danish Physiotherapists
  • Alice Pedersen, community nurse, RN, Faaborg Municipality; Danish Society for Pulmonary Medicine/Allergy Nurses
  • Anne Brandt, managing director of Danmarks Lungeforening (association for patients with pulmonary diseases)
  • Pernille Faurschou, head of section, MPH, Division of Health Care Services, City of Copenhagen; Danish Nurses' Association
  • Malene Juul Hylle, OT, Department of Occupational Therapy, the Regional Hospital in Horsens; Danish Association of Occupational Therapists
  • Reimar Wernich Thomsen, associate professor, consultant in clinical epidemiology, MD, PhD, Competence Centre for Clinical Epidemiology and Biostatistics North, Aarhus (clinical epidemiologist)
  • Henrik Nielsen, biostatistician, MSc, Competence Centre for Clinical Epidemiology and Biostatistics North, Aarhus (statistician)
  • Hans Peter Graversen, Head of Department, Health – Quality and Informatics, Central Denmark Region, Viborg (local authority responsible for data)
  • Katrine Abildtrup Nielsen, Head of Competence Centre, MHsC, Competence Centre for Clinical Quality and Health informatics West, Aarhus (contact person)

Financial Disclosures/Other Potential Conflicts of Interest

Unspecified

Adaptation

This measure was not adapted from another source.

Date of Most Current Version in NQMC

2013 Jan

Measure Maintenance

Every year in connection with the national clinical audit, there may be isolated updates of the indicator sets (e.g., addition of new indicators or new supplementary variables). Every second or third year, there will be a more formalised review with a proper revision of the indicator set, which will also include a complete update of both documentalist report and other documents related to the indicator set.

Date of Next Anticipated Revision

2016 Sep

Measure Status

This is the current release of the measure.

The measure developer reaffirmed the currency of this measure in October 2015.

Source(s)

Indicators in the Danish registry for chronic obstructive pulmonary disease (DrCOPD). Aarhus (DK): Competence Centre for Clinical Quality and Health Informatics West; 2013 Jan 2. 7 p.

Measure Availability

Source not available electronically.

For more information, visit The Competence Centre for Clinical Quality and Health Informatics West Web site External Web Site Policy (in Danish).

Companion Documents

The following is available:

  • Manual for the development of disease-specific quality indicators, standards and prognostic factors under the Danish National Indicator Project. Version 3.0. Arhus N: The Danish National Indicator Project (DNIP); 2009 Jun. 31 p.

NQMC Status

This NQMC summary was completed by ECRI Institute on August 5, 2013. The information was verified by the measure developer on October 1, 2013.

The information was reaffirmed by the measure developer on October 30, 2015.

Copyright Statement

No copyright restrictions apply.

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