Impact of community-based chronic obstructive pulmonary disease service, a multidisciplinary intervention in an area of high deprivation: A longitudinal matched controlled study

Saini, P, Rose, T, Downing, J, Mahata, B, Pilsworth, S, Pemberton, A, Comerford, T, Wilson, K, Shaw, M, Harper, L, Daras, K and Barr, B (2020) Impact of community-based chronic obstructive pulmonary disease service, a multidisciplinary intervention in an area of high deprivation: A longitudinal matched controlled study. BMJ Open, 10 (5). ISSN 2044-6055

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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, five 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 2011–2016. Main outcome measures: Emergency hospital admissions, length of stay per emergency admission, and emergency re-admissions 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 post-intervention 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 amongst 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.

Item Type:	Article
Uncontrolled Keywords:	1103 Clinical Sciences, 1117 Public Health and Health Services, 1199 Other Medical and Health Sciences
Subjects:	R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions:	Psychology (from Sep 2019)
Publisher:	BMJ Publishing
Date of acceptance:	17 April 2020
Date of first compliant Open Access:	27 February 2020
Date Deposited:	27 Feb 2020 11:38
Last Modified:	16 Aug 2022 09:45
DOI or ID number:	10.1136/bmjopen-2019-032931
URI:	https://researchonline.ljmu.ac.uk/id/eprint/12335

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