Abstract
Background:
Section 3025 of the Affordable Care Act added section 1886 (q) to the Social Security Act establishing the Hospital Readmissions Reduction Program, which requires Centers for Medicare and Medicaid Services to reduce payments to hospitals with excess readmissions in six diagnoses. COPD and pneumonia are two of the affected cohorts. Patients with COPD often develop pneumonia and they may require hospitalization if not recognized and treated early in a sub-acute or home care setting. The goal of this study is to evaluate the knowledge of COPD patients on the signs and symptoms of pneumonia.
Methods:
Institutional IRB approvals were obtained. A patient interview form was developed to collect patient data and verbal responses. From review of literatures, seven common signs and symptoms of pneumonia were included in the interview form: (1) cough, (2) mucus production, (3) fever, (4) shortness of breath, (5) chest pain, (6) fatigue, and (7) nausea, vomiting and diarrhea (N/V/D). Patients admitted to a private hospital in South Alabama with a diagnosis of COPD were asked "Do you know the signs and symptoms of a lung infection or pneumonia?" Responses to this and other questions were recorded on the interview form. Data analysis was done by using the frequency count method.
Results:
The results are summarized in the Figure where N represents the total number of patients (12 M and 12 F). The signs and symptoms of pneumonia correctly named by these patients are as follows: Shortness of breath - 9 patients (38%) ; Cough / Mucus production - 7 patients (29%) ; Fatigue - 4 patients (17%) ; Fever / Chest pain - 3 patients (13%) ; N/V/D - 1 patient (4%).
Conclusions:
With a total of 24 patients with COPD, only 10 patients (42%) could name at least one of the common signs and symptoms of pneumonia. Fourteen patients (58%) could not name any common signs and symptoms of pneumonia. Patient education on the recognition of signs and symptoms of pneumonia should be emphasized in the hospital, sub-acute and home care settings. Early recognition and prompt treatment of pneumonia in an out-patient setting may reduce the needs and frequency of hospital admissions. A small sample size from a local private hospital is a limitation of this study.
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