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



Matata, Bashir ORCID: 0000-0003-2896-8059, Saini, Pooja, Downing, Jenifer ORCID: 0000-0001-7691-1167, Harper, Lesley M, Barr, Ben ORCID: 0000-0002-4208-9475, Rose, T, Daras, K ORCID: 0000-0002-4573-4628, Pilsworth, S, Pemberton, A, Comerford, T
et al (show 2 more authors) (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).

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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, 5 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 to 2016. Main outcome measures: Emergency hospital admissions, length of stay per emergency admission and emergency readmissions 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 postintervention 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 among 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
Depositing User: Symplectic Admin
Date Deposited: 01 Jun 2020 08:48
Last Modified: 02 Jun 2020 13:10
DOI: 10.1136/bmjopen-2019-032931
Open Access URL: https://bmjopen.bmj.com/content/10/5/e032931.full?...
URI: http://livrepository.liverpool.ac.uk/id/eprint/3089236