Ventolin is associated with Lower Hospital Readmission Rates for Chronic Obstructive Pulmonary Disease (COPD) Patients at South Shore Hospital based on Real World Evidence Study of Medicare Claims Data

---

In Ventolin, Chronic Obstructive Pulmonary Disease (COPD)

By: Sara Riascos  Mar. 14, 2022

Background:

Chronic Obstructive Pulmonary Disease (COPD) is frequently associated with hospital readmission. Readmission is a hospital quality measure that reflects dimensions of quality of inpatient care and also impacts overall programs by payers such as CMS’s Star Rating Program, HRRP and Value-Based Purchasing.Ventolin (Albuterol) is an Inhaled beta-2-agonist. Studies have shown the use of Ventolin (Albuterol) had an improvement in Chronic obstructive pulmonary disease (COPD) compared to the baseline. Other studies have shown the use of Ventolin (Albuterol) is safe for patients older than four.

Dexur’s analysis of Real-World Evidence based on Medicare Claims data showed that the use of Ventolin within 7 days of hospitalization was associated with lower hospital readmission rates for Chronic obstructive pulmonary disease (COPD) at South Shore Hospital in South Weymouth, Massachusetts . Reduction in readmission rates helps hospitals improve their outcomes for various cost and quality programs. Dexur is an approved entity to perform Medicare claims data analysis, which it uses to perform quality outcomes analysis. Dexur has published several papers with Harvard Medical School on quality outcomes related topics. Dexur’s analysis of Drugs and their impact on quality outcomes, such as readmissions and mortality, are used by Hospitals, IDNs, and ACOs to implement best practices and manage Real World Evidence based risk factors.

Methods:

We conducted a retrospective study using Dexur’s analysis of Real-World Evidence from Medicare Claims data, for hospitalizations at South Shore Hospital between January 2017 to September 2019. Our methodology criteria was as follows:

1. Inclusion Criteria: Selected Medical Hospitalizations with Primary Diagnosis with Chronic Obstructive Pulmonary Disease (COPD) codes (Listed in table below)
2. Stratified Selected population into cohorts
   1. Chronic Obstructive Pulmonary Disease (COPD) patients dispensed Ventolin within 7 Days of Hospitalization using Part D drugs claims database
   2. Chronic Obstructive Pulmonary Disease (COPD) patients not dispense Ventolin within 7 Days of Hospitalization
3. 30 Day readmission rates were analyzed for both population cohorts

Results:

Overall, Ventolin was associated with lower hospital readmission rates for all Primary DRG Diagnosis Codes examined at South Shore Hospital. For patients whose primary DRG Diagnosis was “Chronic obstructive pulmonary disease with (acute) exacerbation” (J441) and when Ventolin was used within 7 days of hospitalization, the readmission rate was 22.06% compared to the cohort where Ventolin was not used, whose readmission rate was 25.85%. The readmission odds ratio for these cohorts was 0.81. The use of Ventolin was associated with a 19% lower readmission rate when used within 7 days of hospitalization. The full list of studied DRG codes, readmission rates, odds ratios, confidence intervals, and percentage reduction in readmission with Ventolin for Chronic Obstructive Pulmonary Disease (COPD) hospitalizations at South Shore Hospital is shown below.

Primary ICD Diagnosis Code	Primary DRG Diagnosis Code Description	Total Hospitalizations without Ventolin	Readmission Without Ventolin	Readmission Rate without Ventolin	Total Hospitalizations with Ventolin	Readmission with Ventolin	Readmission Rate with Ventolin	Readmission Odds Ratio	Reduction in Readmission withVentolin (%)	Confidence Interval (-)	Confidence Intervals (+)
J441	Chronic Obstructive Pulmonary Disease with (acute) exacerbation	1,141

Dexur also leveraged Medicare claims data to understand what percentage of patients hospitalized with Chronic Obstructive Pulmonary Disease (COPD) at major Hospitals were not prescribed Ventolin within 7 days of discharge.

DRG CODE	Hospital	Hospitalizations with COPD	% of Hospitalizations without Ventolin
J441	South Shore Hospital	1,156	98.70%
	St. Luke's Hospital	1,039	98.94%
	Beaumont Hospital - Troy	715	98.18%

Hospitalizations with Chronic Obstructive Pulmonary Disease (COPD) = Above Listed DRG Codes

If figures are shared with “At Least” - this implies that the drug utilization within 7 days post hospitalization is less than 11

Conclusions:

According to analysis of Real-World Evidence of Medicare Claims data, for hospitalizations between January 2017 to September 2019, the use of Ventolin within 7 days of hospitalization can lead to substantial reductions in hospital readmission rates of Chronic obstructive pulmonary disease (COPD) patients at South Shore Hospital. This analysis shows that a significant number of Patients are not dispensed Ventolin after Chronic Obstructive Pulmonary Disease (COPD) hospitalizations at South Shore Hospital or at major US Hospitals.