UNDERUTILIZATION OF SPIROMETRY IN COPD DIAGNOSIS: A PILOT STUDY ON HOSPITAL READMISSIONS
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Authors
Boyd, Kamarin
Department
Healthcare Administration
Issue Date
2025
Type
Thesis
Language
en_US
Keywords
Lungs--Diseases, Obstructive--Diagnosis.::Spirometry
Alternative Title
Abstract
Chronic Obstructive Pulmonary Disease (COPD) is a major contributor to hospital readmissions and healthcare costs. Although spirometry is the gold standard for diagnosing COPD, it remains underutilized in many clinical settings. This pilot study investigated the extent of spirometry use in a mid-sized hospital and its association with 30-day readmission rates. A retrospective analysis of patient data from May to November 2024 found that 62.22% of readmitted COPD patients did not have a documented spirometry test, indicating a substantial gap in adherence to diagnostic guidelines.
While the initial hypothesis proposed that a lack of spirometry would correlate with higher readmission rates, the data did not support this assumption. A surprising negative correlation (r = -0.68) was observed between the percentage of readmitted patients without spirometry and total COPD readmissions. This suggests that higher readmission volumes may coincide with increased provider responsiveness, including improved adherence to diagnostic protocols. Despite the absence of a direct link between spirometry use and readmissions, underutilization still raises concerns about misdiagnosis, inadequate treatment, and overall care quality. Interviews with hospital leadership revealed that COPD readmissions impact Medicare reimbursements under the Hospital Readmissions Reduction Program (HRRP), with potential financial losses estimated between $3,677 and $25,650 during the study period.
To address these challenges, the hospital has implemented provider education, policy changes, and improved tracking systems. This study emphasizes the need for systematic spirometry integration to enhance diagnostic accuracy, improve patient outcomes, and reduce financial penalties, making it both a clinical and operational priority.
Description
Spring 2025 Graduate Project/Thesis/Capstone in Healthcare Administration.
Citation
Publisher
License
A copyright review process in June 2025 has determined that this item is in copyright, held by the author, Kamarin Boyd. The written permission of the copyright holder is required for distribution, reproduction, or other use that extends beyond what is authorized by fair use and other statutory exemptions. Responsibility for making an independent legal assessment of an item and securing any necessary permissions rests with person(s) desiring to use the item. http://rightsstatements.org/vocab/InC-EDU/1.0/