The effect of rehabilitation on health-care utilisation in COPD patients in Copenhagen

Ramune Jacobsen; Ea Rusch; Per Kragh Andersen; John Adams; Cecilia Ravn Jensen; Anne Frølich

doi:10.1111/crj.12074

The effect of rehabilitation on health-care utilisation in COPD patients in Copenhagen

Ramune Jacobsen, Ea Rusch, Per Kragh Andersen, John Adams, Cecilia Ravn Jensen, Anne Frølich

5 Citationer (Scopus)

Abstract

INTRODUCTION: The Integrated Rehabilitation Programme for Chronic Conditions project (SIKS) implemented rehabilitation programmes for people with four chronic conditions in the local area within the Municipality of Copenhagen.

OBJECTIVES: The objective of this study was to evaluate the impact of rehabilitation on health-care utilisation in chronic obstructive pulmonary disease (COPD) patients as a subgroup of SIKS.

METHODS: For the analyses, data from Danish National Registers' were obtained. The following outcomes were analysed: (i) COPD hospital admissions, (ii) COPD bed days, (iii) COPD outpatient visits, (iv) COPD emergency room visits, (v) general practitioner visits, (vi) specialist visits, and (vii) COPD specific medication. The rehabilitation group consisted of 118 patients who completed the programme. The control group consisted of 236 COPD patients in Copenhagen who did not undergo rehabilitation and were matched with the intervention group according to propensity score calculated on the basis of patient socio-demographic characteristics and health-care utilisation pattern in 2 years prior to the rehabilitation programme. The effect was assessed by applying the principle of difference-in-difference analysis.

RESULTS: Compared with their matched controls, the patients participating in the rehabilitation programme showed a statistically significantly smaller increase in hospital admissions, bed days and outpatient visits.

CONCLUSIONS: The study provides the policy decision makers in the Municipality of Copenhagen with an assessment of the effect of a real-life intervention. It shows that the pulmonary rehabilitation programme introduced had the anticipated effects on health-care utilisation. The study also suggests that the methods used for evaluation were appropriate.

Originalsprog	Engelsk
Tidsskrift	Clinical Respiratory Journal
Vol/bind	8
Udgave nummer	3
Sider (fra-til)	321-9
Antal sider	9
ISSN	1752-6981
DOI	https://doi.org/10.1111/crj.12074
Status	Udgivet - jul. 2014

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10.1111/crj.12074

Citationsformater

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title = "The effect of rehabilitation on health-care utilisation in COPD patients in Copenhagen",

abstract = "INTRODUCTION: The Integrated Rehabilitation Programme for Chronic Conditions project (SIKS) implemented rehabilitation programmes for people with four chronic conditions in the local area within the Municipality of Copenhagen.OBJECTIVES: The objective of this study was to evaluate the impact of rehabilitation on health-care utilisation in chronic obstructive pulmonary disease (COPD) patients as a subgroup of SIKS.METHODS: For the analyses, data from Danish National Registers' were obtained. The following outcomes were analysed: (i) COPD hospital admissions, (ii) COPD bed days, (iii) COPD outpatient visits, (iv) COPD emergency room visits, (v) general practitioner visits, (vi) specialist visits, and (vii) COPD specific medication. The rehabilitation group consisted of 118 patients who completed the programme. The control group consisted of 236 COPD patients in Copenhagen who did not undergo rehabilitation and were matched with the intervention group according to propensity score calculated on the basis of patient socio-demographic characteristics and health-care utilisation pattern in 2 years prior to the rehabilitation programme. The effect was assessed by applying the principle of difference-in-difference analysis.RESULTS: Compared with their matched controls, the patients participating in the rehabilitation programme showed a statistically significantly smaller increase in hospital admissions, bed days and outpatient visits.CONCLUSIONS: The study provides the policy decision makers in the Municipality of Copenhagen with an assessment of the effect of a real-life intervention. It shows that the pulmonary rehabilitation programme introduced had the anticipated effects on health-care utilisation. The study also suggests that the methods used for evaluation were appropriate.",

keywords = "Aged, Ambulatory Care, Case-Control Studies, Denmark, Female, Humans, Length of Stay, Male, Patient Admission, Program Evaluation, Propensity Score, Pulmonary Disease, Chronic Obstructive, Registries",

author = "Ramune Jacobsen and Ea Rusch and Andersen, {Per Kragh} and John Adams and Jensen, {Cecilia Ravn} and Anne Fr{\o}lich",

note = "{\textcopyright} 2013 John Wiley & Sons Ltd.",

year = "2014",

month = jul,

doi = "10.1111/crj.12074",

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volume = "8",

pages = "321--9",

journal = "Clinical Respiratory Journal",

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TY - JOUR

T1 - The effect of rehabilitation on health-care utilisation in COPD patients in Copenhagen

AU - Jacobsen, Ramune

AU - Rusch, Ea

AU - Andersen, Per Kragh

AU - Adams, John

AU - Jensen, Cecilia Ravn

AU - Frølich, Anne

PY - 2014/7

Y1 - 2014/7

N2 - INTRODUCTION: The Integrated Rehabilitation Programme for Chronic Conditions project (SIKS) implemented rehabilitation programmes for people with four chronic conditions in the local area within the Municipality of Copenhagen.OBJECTIVES: The objective of this study was to evaluate the impact of rehabilitation on health-care utilisation in chronic obstructive pulmonary disease (COPD) patients as a subgroup of SIKS.METHODS: For the analyses, data from Danish National Registers' were obtained. The following outcomes were analysed: (i) COPD hospital admissions, (ii) COPD bed days, (iii) COPD outpatient visits, (iv) COPD emergency room visits, (v) general practitioner visits, (vi) specialist visits, and (vii) COPD specific medication. The rehabilitation group consisted of 118 patients who completed the programme. The control group consisted of 236 COPD patients in Copenhagen who did not undergo rehabilitation and were matched with the intervention group according to propensity score calculated on the basis of patient socio-demographic characteristics and health-care utilisation pattern in 2 years prior to the rehabilitation programme. The effect was assessed by applying the principle of difference-in-difference analysis.RESULTS: Compared with their matched controls, the patients participating in the rehabilitation programme showed a statistically significantly smaller increase in hospital admissions, bed days and outpatient visits.CONCLUSIONS: The study provides the policy decision makers in the Municipality of Copenhagen with an assessment of the effect of a real-life intervention. It shows that the pulmonary rehabilitation programme introduced had the anticipated effects on health-care utilisation. The study also suggests that the methods used for evaluation were appropriate.

AB - INTRODUCTION: The Integrated Rehabilitation Programme for Chronic Conditions project (SIKS) implemented rehabilitation programmes for people with four chronic conditions in the local area within the Municipality of Copenhagen.OBJECTIVES: The objective of this study was to evaluate the impact of rehabilitation on health-care utilisation in chronic obstructive pulmonary disease (COPD) patients as a subgroup of SIKS.METHODS: For the analyses, data from Danish National Registers' were obtained. The following outcomes were analysed: (i) COPD hospital admissions, (ii) COPD bed days, (iii) COPD outpatient visits, (iv) COPD emergency room visits, (v) general practitioner visits, (vi) specialist visits, and (vii) COPD specific medication. The rehabilitation group consisted of 118 patients who completed the programme. The control group consisted of 236 COPD patients in Copenhagen who did not undergo rehabilitation and were matched with the intervention group according to propensity score calculated on the basis of patient socio-demographic characteristics and health-care utilisation pattern in 2 years prior to the rehabilitation programme. The effect was assessed by applying the principle of difference-in-difference analysis.RESULTS: Compared with their matched controls, the patients participating in the rehabilitation programme showed a statistically significantly smaller increase in hospital admissions, bed days and outpatient visits.CONCLUSIONS: The study provides the policy decision makers in the Municipality of Copenhagen with an assessment of the effect of a real-life intervention. It shows that the pulmonary rehabilitation programme introduced had the anticipated effects on health-care utilisation. The study also suggests that the methods used for evaluation were appropriate.

KW - Aged

KW - Ambulatory Care

KW - Case-Control Studies

KW - Denmark

KW - Female

KW - Humans

KW - Length of Stay

KW - Male

KW - Patient Admission

KW - Program Evaluation

KW - Propensity Score

KW - Pulmonary Disease, Chronic Obstructive

KW - Registries

U2 - 10.1111/crj.12074

DO - 10.1111/crj.12074

M3 - Journal article

C2 - 24279723

SN - 1752-6981

VL - 8

SP - 321

EP - 329

JO - Clinical Respiratory Journal

JF - Clinical Respiratory Journal

IS - 3

ER -

The effect of rehabilitation on health-care utilisation in COPD patients in Copenhagen

Abstract

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