Entries for 'emergency department use'
Mandeep Singh, MD1 En Shuo Hsu, BA2 Efstathia Polychronopoulou, PhD2 Gulshan Sharma, MD, MPH1 Alexander G. Duarte, MD1
Author Affiliations
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, United States
- Office of Biostatistics, University of Texas Medical Branch, Galveston, Texas, United States
Address correspondence to:
Alexander Duarte, MD
Division of Pulmonary, Critical Care, and Sleep Medicine
University of Texas Medical Branch
301 University Blvd.
Galveston, TX 77555
Phone: (409) 772-2436
Email: aduarte@utmb.edu
Abstract
Background: Chronic obstructive pulmonary disease (COPD) is an ambulatory care-sensitive condition.
Methods: We compared the impact of care received by patients with COPD at Joint Commission-accredited, disease-specific clinics and primary care clinics at an academic health care systemfrom April 2014 to March 2018. Patients with COPD ≥ 40 years old with ≥ 2 outpatient visits 30 days apart were identified. Baseline demographics, disease-specific performance measures, and health care utilization were compared between groups. Propensity matching was conducted and time to the first emergency department (ED) visit and hospitalization was performed using Cox regression analysis.
Results: Of 4646 unique patients with COPD, 1114 were treated at disease-specific clinics and 3532 at primary care clinics. The entire group was predominantly female (58.8 %), non-Hispanic White (74.2 %) with a mean age of 65.4 ± 11.4 years consisting of current (47.6 %) or former smokers (38.4 %). In the disease-specific group, performance measures were performed more frequently, and lower rates of ED visits (hazard ratio [HR]=0.31, 95% confidence interval [CI] 0.18–0.54) and hospitalizations (HR 0.41, 95% CI 0.21–0.79) noted in comparison to the primary care group.
Conclusion: In this observational study, the implementation of achronic disease management program through accredited disease-specific clinics for patients with COPD was associated with reduced all-cause ED visits and hospitalizations.
Citation
Citation: Singh M, Hsu ES, Polychronopoulou E, Sharma G, Duarte AG. Structured evaluation and management of patients with COPD in an accredited program. J COPD F. 2023; 10(3): 297-307. doi: http://doi.org/10.15326/jcopdf.10.3.2022.0366