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Rachel Gavish, MD, MPH; Amalia Levy, PhD, MPH; Or Kalchiem Dekel, MD; Erez Karp, MD; Nimrod Maimon, MD
Author and Funding Information

From the Department of Public Health (Drs Gavish and Levy), the Department of Medicine (Drs Dekel and Karp), and the Department of Pulmonology (Dr Maimon), Faculty of Health Sciences, Ben-Gurion University of the Negev; and Soroka University Medical Center (Drs Dekel, Karp, and Maimon).

CORRESPONDENCE TO: Nimrod Maimon, MD, Division of Pulmonology, Soroka University Medical Center, POB 151, Beer-Sheva 84111, Israel; e-mail: nimrod@bgu.ac.il


FINANCIAL/NONFINANCIAL DISCLOSURES: The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2015;148(2):e63. doi:10.1378/chest.15-0956
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To the Editor:

We thank Drs Hatipoğlu and Wang for their interest in our article in this issue of CHEST1 on the association between hospital readmission and pulmonologist follow-up visits of patients with COPD. We agree that the question about how to reduce readmissions from any cause in patients with COPD is important, and it is still open for future studies. In our research, we did not define it as our main objective. We intentionally chose rehospitalization related to COPD exacerbation as an end point. We did not anticipate that a follow-up visit with a pulmonologist, who focused on the respiratory condition and on tailoring the right treatment of the patient’s respiratory illness, would reduce all readmission causes. We see a great significance in preventing some of the readmissions of patients with COPD, even for just a portion of that group.

Regarding the statistical methods that were used in the modeling process: In the final model of the risk factors for readmission within 90 days and in the Cox proportional hazard model, we did not include a previous visit with a pulmonologist as a covariate. The reason is that in the primary process of one-variable analysis, this factor did not have a significant association. Therefore, it was excluded from the final model.

We agree that the types of the following variables need to be clarified: previous hospitalizations and previous visit with a pulmonologist. In all the models (except the Cox regression model), these variables were entered as count numbers. In the Cox regression model, the variable “previous hospitalizations” was entered as a dichotomous variable (none; one and above) to prevent interaction that occurred during the process. This modification and others in this model were noted in Table 4 in the article.

References

Gavish R, Levy A, Dekel OK, Karp E, Maimon N. The association between hospital readmission and pulmonologist follow-up visits in patients with COPD. Chest. 2015;148(2):375-381.
 

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References

Gavish R, Levy A, Dekel OK, Karp E, Maimon N. The association between hospital readmission and pulmonologist follow-up visits in patients with COPD. Chest. 2015;148(2):375-381.
 
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