Operational Modeling with Health Economics to Support Decision Making for COPD Patients

Area of Science:

• Health economics
• Respiratory medicine
• Health services research

Background:

• Chronic obstructive pulmonary disease (COPD) management requires effective interventions.
• Pulmonary rehabilitation (PR) is a key component of COPD care.
• Assessing the impact of increased PR on patient outcomes and cost-effectiveness is crucial.

Purpose of the Study:

• To evaluate the impact of enhanced pulmonary rehabilitation (PR) utilization on patient outcomes in chronic obstructive pulmonary disease (COPD) management.
• To conduct a cost-benefit analysis of increased PR interventions for COPD patients.
• To develop and utilize a simulation model for assessing COPD patient pathways and intervention impacts.

Main Methods:

• Discrete event simulation (DES) was employed to model the COPD patient pathway.
• A health economic model was integrated with DES to calculate net benefit and cost.
• Data from Hospital Episode Statistics (HES), hospital/community services, and literature were used to parameterize the model.

Main Results:

• Increased PR referrals (10-30%) demonstrated cost-effectiveness with benefit-cost ratios ranging from 5.81 to 5.95.
• A 30% increase in PR referrals led to a decrease in deaths, admissions, and bed days.
• Patient quality of life improved, with an increase of 5.53 QALY per 1540 patients for a 30% PR referral increase.

Conclusions:

• The developed simulation model is the first to capture the COPD patient pathway in a hospital setting.
• This study provides novel insights into the operational and economic impact of PR on COPD services.
• Findings support policies advocating for expanded PR availability as a primary COPD intervention.