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Evaluation of a disease management program for COPD using propensity matched control group.

Pradeep Paul George1, Bee Hoon Heng1, Tow Keang Lim2

  • 1Health Services & Outcomes Research (HSOR), National Healthcare Group HQ, Singapore ;

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Summary

Disease management programs (DMPs) for chronic obstructive pulmonary disease (COPD) reduced mortality but increased hospital readmissions. This suggests DMPs improve survival but require further optimization for resource utilization in COPD care.

Keywords:
Pulmonary diseasecase managementchronic obstructivedisease management program (DMP)mortalityreadmission

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Area of Science:

  • Pulmonary Medicine
  • Health Services Research
  • Clinical Epidemiology

Background:

  • Disease management programs (DMPs) are increasingly used to enhance care for chronic illnesses.
  • Chronic obstructive pulmonary disease (COPD) presents a significant health burden globally and in Singapore.
  • DMPs aim to reduce mortality, hospitalizations, and length of hospital stay for COPD patients.

Purpose of the Study:

  • To evaluate the effectiveness of a DMP for COPD patients.
  • To compare outcomes of DMP participants with propensity score-matched controls.
  • To assess the impact of DMP on mortality, readmission, and hospital utilization.

Main Methods:

  • Propensity score matching was used to compare DMP patients with non-enrolled COPD patients.
  • Control patients were selected from the Operations Data Store (ODS) database.
  • Outcomes analyzed included length of stay, hospital days, readmission rates, and mortality.

Main Results:

  • DMP participation was associated with significantly lower mortality rates (0.12 vs. 0.27 per person-year).
  • One-year survival was higher for DMP patients (91%) compared to controls (76%).
  • DMP patients experienced higher readmission rates and total hospital days per person-year.

Conclusions:

  • Participation in the DMP is linked to reduced all-cause mortality in COPD patients.
  • The observed survival benefit paradoxically coincided with increased readmission rates and hospital days.
  • Further research is needed to optimize DMPs for improved resource management alongside survival gains.