Study: COPD among top reasons for admission to SRMC
A statewide hospital patient study revealed that one of the top reasons for admission to Southwest Regional Medical Center (SRMC) in Greene County is chronic obstructive pulmonary disease (COPD).
Joy Eggleston, senior public affairs officer at the hospital, said the illness’ third place ranking for admissions in the county can be credited to the long-time occupation of many who live there: coal mining.
“COPD is in our top three, which is pretty different than the rest of the state. There are a lot of men who work in the coal mines where there are a lot of dust and coal particles that contribute to breathing problems,” said Eggleston. “We’ve seen a lot of that over the years.”
The “super-utilizer” study released by the Pennsylvania Health Care Cost Containment Council (PHC4) analyzes the statistical information of patients with five or more admissions to an acute care hospital between July 1, 2013 and June 30, 2014. The study doesn’t include data of residents below the age of 18, or cases of maternity or rehabilitation. They also do not track patient visits that don’t result in hospitalization.
The study further states that “these individuals often move between emergency departments and inpatient admissions and readmissions, and often across different hospitals or health systems. The result is high healthcare costs that might have been prevented through early intervention and collaborative care.”
According to the study, of 10,000 people, 21 were admitted to SRMC more than five times for problems relating to COPD. The other two high-ranking reasons for admission to the Greene County hospital were mental health disorders and heart failure with 39 and 29 cases respectively.
Compared to the rest of the state and neighboring Fayette County, the numbers were significantly less, Eggleston said. Overall, Fayette County had 30.8 admissions cases per 10,000, while Greene County only had 16.8.
“We would point our success to our commitment to managing each patient while in the hospital, and ensuring their follow up plan for discharge is clearly defined,” she said. “The key is to provide education to the patient after they’re discharged.”
Eggleston said this is done in their hospital by working with the patient to create a clear plan for their needs, setting up follow up appointments with physicians and working with caretakers.
In Fayette County, heart failure, mental health disorders and septicemia (a life-threatening complication of an infection) topped the list with 177, 175 and 108 cases per 10,000 respectively.
Multiple calls and messages seeking comment from officials at Uniontown Hospital and Highlands Hospital in Connellsville, which both service Fayette County, were not returned.
In Washington County, Monongahela Valley Hospital is collaborating with “downstream providers” who provide services to people once they are discharged, according to senior vice president Donna Ramusivich.
Results in Washington County indicated that the top ranking reasons for admission during the study were mental health disorders, heart failure and septicemia with 335, 223 and 178 cases per 10,000 respectively.
Noting that heart failure and septicemia were primarily conditions of the elderly, Ramusivich said the hospital often works with nursing homes and personal care homes to further educate them on treatment and preventative measures.
“We really weren’t surprised by the results,” said Ramusivich, adding that the county has a high elderly population. As for the most common cause for re-admittance, mental health disorders, it could be credited to them having a behavioral health unit, she said.
The study found that the super-utilizers make up 3 percent of hospitalized patients (about 21,308 individuals) in the state. Of that 3 percent, 69 percent of them had five to six hospital admissions while 12 percent had more than nine admissions.
“There is a relatively small subset of patients that account for a disproportionately large spending in health care,” said the founder and executive director of PHC4, Joe Martin.
“There are a lot of discussions in health care circles on how to treat this,” he said. He provided an example with cases like diabetes and asthma, adding that those cases might be better managed in other settings. “You want to be able to treat a diabetic before it gets too serious — before it requires admittance to the hospital.”
Martin indicated in the news release that super-utilizers “accounted for $761 million of Medicare and Medicaid expenditures for inpatient stays in Pennsylvania.”
“Having data on super-utilizers will help the Commonwealth’s policy makers and health care professionals as they determine the best way to care for those with chronic care needs while containing costs,” he said.