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Updated: May 9, 2026
07:10
Home-Based Prescribed Pulmonary Exercise in Patients with Stable Chronic Obstructive Pulmonary Disease
Published on: August 24, 2019
Economic assessment of home-based COPD management programs.
Sheena Xin Liu1, Michael C Lee, Maryam Atakhorrami
11Philips Research North America, Briarcliff Manor, NY, United States.
COPD
|July 16, 2013
Summary
Home-based management programs for chronic obstructive pulmonary disease (COPD) exacerbations show economic viability. Risk stratification is key to optimizing cost and clinical outcomes for these telehealth interventions.
Area of Science:
- Pulmonary Medicine
- Health Economics
- Health Services Research
Background:
- Home-based exacerbation management programs are proposed to reduce the burden of chronic obstructive pulmonary disease (COPD).
- Evaluating these programs is crucial for optimizing cost and clinical outcomes.
- Existing models lack a framework for guiding program design and performance decisions.
Purpose of the Study:
- To develop and demonstrate a framework for evaluating hypothetical home-based COPD exacerbation management programs.
- To guide program design and performance decisions for optimizing cost and clinical outcomes.
- To assess the economic viability and impact of telehealth interventions for COPD exacerbations.
Main Methods:
- Probabilistic Markov simulations were used to model the impact of hypothetical exacerbation management programs.
- Patients were stratified by risk using exacerbation rates from the ECLIPSE study and expert opinion.
- Three scenarios (base, worst, best case) were modeled to assess potential telehealth program performance.
Main Results:
- Early detection of acute exacerbations had a sensitivity and specificity ranging from 60-90%.
- Detected exacerbations could be diverted to sub-acute pathways (12.5-50% probability) or reduce hospital length-of-stay (14-28% reduction).
- Significant per-patient lifetime savings were projected: $2.9K for lower-risk and $16K for higher-risk cohorts.
Conclusions:
- Home-based exacerbation management programs demonstrate economic viability for COPD.
- Risk stratification is important for optimizing the performance and cost-effectiveness of these programs.
- The presented model can be adapted to evaluate specific programs as trial data becomes available.
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