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

Collapse authors list.
Saini, Pooja ORCID: 0000-0002-4981-7914, Rose, T, Downing, Jenifer ORCID: 0000-0001-7691-1167, Matata, Bashir ORCID: 0000-0003-2896-8059, Pilsworth, S, Pemberton, A, Comerford, T, Wilson, K, Shaw, Matthew, Harper, Lesley M ORCID: 0000-0003-1065-5732 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). e032931-.

This is the latest version of this item.

Access the full-text of this item by clicking on the Open Access link.

	Text Main Document_v2_TR PS -LH.docx - Author Accepted Manuscript Available under License : See the attached licence file. Download (107kB)
	Text Main Document 110719.docx - Author Accepted Manuscript Available under License : See the attached licence file. Download (99kB)

Official URL: https://bmjopen.bmj.com/content/10/5/e032931

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
Uncontrolled Keywords:	COPD, pulmonary rehabilitation, respiratory medicine (see thoracic medicine), readmission, A&E attendance, community care multidisciplinary
Depositing User:	Symplectic Admin
Date Deposited:	21 Jul 2020 07:46
Last Modified:	18 Jan 2023 23:49
DOI:	10.1136/bmjopen-2019-032931
Open Access URL:	https://bmjopen.bmj.com/content/bmjopen/10/5/e0329...
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3090548