Abstract:
OBJECTIVE:To examine the effects of a consultant-led, community-based chronic obstructive pulmonary disease (COPD) service, based in a highly deprived area on emergency hospital admissions. DESIGN:A longitudinal matched controlled study using difference-in-differences analysis to compare the change in outcomes in the intervention population to a matched comparison population, 5 years before and after implementation. SETTING:A deprived district in the North West of England between 2005 and 2016. INTERVENTION:A community-based, consultant-led COPD service providing diagnostics, treatment and rehabilitation from 2011 to 2016. MAIN OUTCOME MEASURES:Emergency hospital admissions, length of stay per emergency admission and emergency readmissions for COPD. RESULTS:The intervention was associated with 24 fewer emergency COPD admissions per 100 000 population per year (95% CI -10.6 to 58.8, p=0.17) in the postintervention period, relative to the control group. There were significantly fewer emergency admissions in populations with medium levels of deprivation (64 per 100 000 per year; 95% CI 1.8 to 126.9) and among men (60 per 100 000 per year; 95% CI 12.3 to 107.3). CONCLUSION:We found limited evidence that the service reduced emergency hospital admissions, after an initial decline the effect was not sustained. The service, however, may have been more effective in some subgroups.
journal_name
BMJ Openjournal_title
BMJ openauthors
Saini P,Rose T,Downing J,Matata B,Pilsworth S,Pemberton A,Comerford T,Wilson K,Shaw M,Harper LM,Daras K,Barr Bdoi
10.1136/bmjopen-2019-032931subject
Has Abstractpub_date
2020-05-27 00:00:00pages
e032931issue
5issn
2044-6055pii
bmjopen-2019-032931journal_volume
10pub_type
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