Identifying potentially cost effective chronic care programs for people with COPD
L M G Steuten1, K M M Lemmens2, A P Nieboer2, H JM Vrijhoef3
1Maastricht University Medical Centre, School for Care and Public Health Research, Department of Health, Organisation, Policy and Economics, Maastricht, The Netherlands; 2Erasmus University Medical Centre, Institute of Health Policy and Management, Rotterdam, The Netherlands; 3Maastricht University Medical Centre, School for Care and Public Health Research, Department of Integrated Care, Maastricht, The Netherlands
Objective: To review published evidence regarding the cost effectiveness of multi-component COPD programs and to illustrate how potentially cost effective programs can be identified.
Methods: Systematic search of Medline and Cochrane databases for evaluations of multi-component disease management or chronic care programs for adults with COPD, describing process, intermediate, and end results of care. Data were independently extracted by two reviewers and descriptively summarized.
Results: Twenty articles describing 17 unique COPD programs were included. There is little evidence for significant improvements in process and intermediate outcomes, except for increased provision of patient self-management education and improved disease-specific knowledge. Overall, the COPD programs generate end results equivalent to usual care, but programs containing ≥3 components show lower relative risks for hospitalization. There is limited scope for programs to break-even or save money.
Conclusion: Identifying cost effective multi-component COPD programs remains a challenge due to scarce methodologically sound studies that demonstrate significant improvements on process, intermediate and end results of care. Estimations of potential cost effectiveness of specific programs illustrated in this paper can, in the absence of ‘perfect data’, support timely decision-making regarding these programs. Nevertheless, well-designed health economic studies are needed to decrease the current decision uncertainty.
Keywords: chronic care management, COPD, cost-effectiveness, review
This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.Download Article [PDF]
Readers of this article also read:
Home-based pulmonary rehabilitation in patients with chronic obstructive pulmonary disease: a randomized clinical trial
Dias FD, Sampaio LMM, da Silva GA, Dantas Gomes ELF, Nascimento ESP, Santos Alves VL, Stirbulov R, Costa D
Published Date: 5 November 2013
Almagro P, Castro A
Published Date: 24 July 2013
Suzanne C Lareau, Barbara P Yawn
Published Date: 24 November 2010
Arnulf Langhammer, Siri Forsmo, Unni Syversen
Published Date: 30 September 2009
Paul A Ford, Richard EK Russell, Peter J Barnes
Published Date: 31 July 2009
Florence Ader, Anne-Lise Bienvenu, Blandine Rammaert, et al.
Published Date: 24 July 2009
Impact of frequency of COPD exacerbations on pulmonary function, health status and clinical outcomes
A Anzueto, I Leimer, S Kesten
Published Date: 24 June 2009
Beta-blockers and health-related quality of life in patients with peripheral arterial disease and COPD
Yvette RBM van Gestel, Sanne E Hoeks, Don D Sin, Henk Stam, Frans W Mertens, Jeroen J Bax, Ron T van Domburg, Don Poldermans
Published Date: 8 May 2009
Measurement of tumor necrosis factor-α, leukotriene B4, and interleukin 8 in the exhaled breath condensate in patients with acute exacerbations of chronic obstructive pulmonary disease
Fanny WS Ko, Ting-Fan Leung, Gary WK Wong, Jenny Ngai, Kin W To, et al
Published Date: 10 December 2008
Brendan Corkery, Norma O’Donovan, John Crown
Published Date: 16 September 2008