To assess the effectiveness of a Nurse-led care coordination program in reducing hospital utilisation, in patients with chronic obstructive pulmonary disease (COPD).
We examined hospital admissions in a cohort of patients admitted to our acute hospital facility with a primary diagnosis of COPD, and who were referred for inclusion in our Nurse-led care coordination program (Program Cohort). We compared the number of admissions in the 12 months before and after referral, and also examined admission rates of a cohort of like patients, who had not been referred to the program (Standard Care Cohort). Essential elements of this program were: 1) practice redesign across the continuum of care to align practice with current guidelines; 2) capacity-building, by education of involved health professionals and patients, and by enhancement of rehabilitation and self support programs; 3) self-management monitoring by a dedicated nurse practitioner, and 4) coordination of additional service provision by the same nurse practitioner.
The Program Cohort (n=78) had 164 admissions pre-program, compared to 9 post-program. Standard Care Cohort (n=65) had 124 and 59 admissions respectively during the same time frame. Admissions were reduced to a significantly greater degree in the Program Cohort (Pearson’s X 2=42.073, df=1, P<0.001).
Participation in a Nurse-led care coordination program was associated with a signficant reduction in hospital demand for the ensuing 12 months.
This study supports the introduction of a Nurse-led care coordination program in reducing hospital demand for patients with COPD.
G.M. Russell, None.