Rural Versus Urban Differences in Hospital Readmissions, Inpatient Mortality, and Cost Among COPD Patients

The overall aims of this dissertation were to identify factors that impacted 30-day COPD readmissions, inpatient mortality, and overall cost of care. Differences in area of residence were also assessed for all three outcomes. Finally, comorbidities were analyzed to determine their effects on 30-day readmission rates, inpatient mortality, and total cost of care. This dissertation employed quantitative research and used data from the 2016 Nationwide Readmission Database dataset (NRD) and the 2016 National (Nationwide) Inpatient Sample Database dataset from the Health Care Cost and Utilization Project (HCUP). Descriptive statistics were used to report mean (standard deviation, SD) for continuous variables. Binary logistic regression and multiple logistic regression were used for categorical variables. Chi-square testing was used to determine significance of the association between independent and dependent variables related to mortality. A generalized linear model (GLM) with family gamma, long link and margins command was used in the cost analysis. Findings from these studies outlined several variables that led to increased readmission, increased odds of mortality, and increased overall cost of care. When looking at differences depending on residence; insurance type, hospital location, age, median household income, and certain comorbidities had effects on readmission rates, odds of mortality, and overall costs.