Thomas L. Keller, MD, MS; Jennifer Wright, MD; Lucas M. Donovan, MD, MS; Laura J. Spece, MD, MS; Kevin Duan, MD; Nadiyah Sulayman, BA; Alexandria Dominitz, BA; J. Randall Curtis, MD, MPH; David H. Au, MD, MS; Laura C. Feemster, MD, MS
Despite prior improvement efforts, the quality of COPD care provided in outpatient settings (physician’s offices, clinics, emergency departments, etc.) is poor. Hoping to learn information that could be used in the future to create plans or programs to improve care, we performed a study to identify the characteristics of both patients and their primary care providers that might be associated with high-quality outpatient COPD care.
We identified a group of patients who had been diagnosed with COPD by a physician and who had received care at 2 University of Washington-affiliated primary care clinics between June 1, 2011, and June 1, 2013. Among these patients, we looked at whether they received, over a 1-year period, the specific outpatient COPD care measures that are recommended in expert COPD guidelines. We also studied whether specific characteristics of the patient or the primary care provider had an impact on the overall quality of the outpatient COPD care they received.
We found that in the group we studied, the quality of care provided in the outpatient setting was poor and patients, on average, only received 66% of the care recommended in COPD guidelines. Patients who saw a pulmonologist received 1-2 additional COPD quality measures when compared with patients who did not.
Other patient characteristics (e.g., comorbidities [other illnesses], insurance status, number of outpatient visits) and provider factors (e.g., years in practice, highest degree attained) were not associated with the receiving of the COPD care recommended in expert COPD guidelines.
Our findings suggest the need for future studies to investigate if involving pulmonary specialty providers in the management of patients with COPD can improve outpatient COPD care quality.