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Structured Evaluation and Management of Patients with COPD in an Accredited Program
Mandeep Singh1, En Shuo Hsu2, Efstathia Polychronopoulou2
1Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, United States.
Chronic Obstructive Pulmonary Diseases (Miami, Fla.)
|July 14, 2023
Summary
Disease-specific clinics significantly reduced emergency department visits and hospitalizations for chronic obstructive pulmonary disease (COPD) patients. This highlights the benefit of specialized chronic disease management programs for COPD care.
Area of Science:
- Pulmonary Medicine
- Health Services Research
- Chronic Disease Management
Background:
- Chronic obstructive pulmonary disease (COPD) is recognized as an ambulatory care-sensitive condition.
- Effective management strategies are crucial to reduce healthcare utilization and improve patient outcomes.
- Variations in care delivery models may impact health outcomes for COPD patients.
Purpose of the Study:
- To compare the impact of care received by COPD patients at accredited disease-specific clinics versus primary care clinics.
- To evaluate differences in healthcare utilization, specifically emergency department (ED) visits and hospitalizations.
- To assess the effectiveness of a chronic disease management program implemented in specialized clinics.
Main Methods:
- An observational study comparing 1114 patients from disease-specific clinics and 3532 from primary care clinics within an academic health system (April 2014-March 2018).
- Inclusion criteria: COPD patients aged ≥40 with ≥2 outpatient visits 30 days apart.
- Propensity matching and Cox regression analysis were used to compare time to first ED visit and hospitalization.
Main Results:
- Patients at disease-specific clinics had performance measures completed more frequently.
- Significantly lower rates of ED visits (HR=0.31) and hospitalizations (HR=0.41) were observed in the disease-specific group compared to the primary care group.
- The study included a predominantly female (58.8%) non-Hispanic White (74.2%) population with a mean age of 65.4 years, comprising current or former smokers.
Conclusions:
- Implementation of a chronic disease management program via accredited disease-specific clinics is associated with reduced all-cause ED visits and hospitalizations for COPD patients.
- Specialized care models may offer advantages in managing ambulatory care-sensitive conditions like COPD.
- This suggests that disease-specific clinics can improve care efficiency and reduce acute healthcare episodes for COPD management.
Keywords:
COPDJoint Commissionaccreditationchronic disease managementemergency department usehealth care utilizationhospitalizationsMore Related Videos
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