Obstructive Lung Diseases |

Retrospective Review of the Impact of a Chronic Obstructive Pulmonary Disease (COPD) Comprehensive Case Program on Hospital Readmission Rates FREE TO VIEW

Abdulmajeed Alshabanat; Carmen Rampel; Jane Burns; Don Sin; Jeremy Road; J FitzGerald
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Institute for Heart and Lung Health (IHLH), Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada

Chest. 2015;148(4_MeetingAbstracts):715A. doi:10.1378/chest.2278816
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SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: COPD accounts for the highest rate of hospital admission among major chronic diseases across Canada. COPD hospitalizations are associated with impaired quality of life, high health-care utilization, and worse prognosis, and result in an economic and social burden that is both substantial and increasing.The aim of this study was to determine the efficacy of a comprehensive care management program (CCMP) in reducing the length of stay (LOS) and risk of hospital admissions in patients with COPD.

METHODS: We retrospectively compared outcomes following the implementation of a systems approach to the management of COPD patients who were identified in the hospital and followed-up for 90 days.

RESULTS: 1073 patients with a clinical diagnosis of COPD were identified from 2442 hospital admissions during the three years of study. Progressively fewer patients and admissions were observed over the three years of study. The disease management program reduced COPD-related hospitalizations by 47%, hospitalizations for all causes by 32%. In comparison to the year prior to program, the average number of readmissions for a patient fell from 0.78 to 0.63 and 0.31 during program years 1 and 2, respectively. Similarly, the probability of readmission with a primary diagnosis of COPD showed a significant decline, with HR of 0.37 and 0.18 (p<0.001). In addition, patients mean LOS for all causes and COPD related admissions declined from 8.4 and 8.2 to 7.2 and 7.0 days, respectively.

CONCLUSIONS: A comprehensive case management program for COPD patients including education, case management, and follow-up was associated with significant reduction in ED visits, hospital admissions and length of stay.

CLINICAL IMPLICATIONS: The findings of the present study allow us to conclude that a comprehensive case management program for patients with COPD is an effective intervention in reducing health-care utilization, with beneficial effects that extend beyound COPD-related emergency visits and hospitalizations.

DISCLOSURE: The following authors have nothing to disclose: Abdulmajeed Alshabanat, Carmen Rampel, Jane Burns, Don Sin, Jeremy Road, J FitzGerald

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