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UBC Theses and Dissertations

Impact of a Chronic Obstructive Pulmonary Disease (COPD) comprehensive case management program on hospital length of stay and readmission rates Alshabanat, Abdulmajeed

Abstract

Chronic Obstructive Pulmonary Disease (COPD) is a common chronic airway disease characterized by progressive airway limitation and significant social and economic burden. Hospitalizations due to COPD account for the greatest portion of the economic costs for this disease. Unplanned COPD readmissions greatly impact the patient and healthcare costs and, to some extent, are related to gaps in the healthcare system such as discharge planning and post-discharge care and follow-up. Identifying and targeting factors contributing to unplanned rehospitalizations could reduce healthcare costs and improve COPD patients' health outcomes. We retrospectively examined the outcome and efficacy of a comprehensive case management program in reducing the length of stay and hospital readmissions in patients with COPD across five large hospitals in Vancouver, BC, Canada. A total of 1,564 patients with a clinical diagnosis of COPD were identified from 2,719 hospital admissions during the 3 years of study. The disease management program reduced COPD-related hospitalizations by 30% and hospitalizations for all causes by 13.6%. Similarly, the rate of readmission for all causes showed a significant decline, with hazard ratios (HRs) of 0.55 (year 1) and 0.51 (year 2) of intervention (P<0.001). In addition, patients’ mean LOS (days) for COPD-related admissions declined significantly from 10.8 to 6.8 (P<0.05).

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