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Ewa Bandurska, Iwona Damps-Konstańska, Piotr Popowski, Tadeusz Jędrzejczyk, Piotr Janowiak, Katarzyna Świętnicka, Marzena Zarzeczna-Baran, Ewa Jassem
(Department of Public Health and Social Medicine, Medical University of Gdańsk, Gdańsk, Poland)
Med Sci Monit 2017; 23:2850-2862
Chronic obstructive pulmonary disease (COPD) is a commonly diagnosed condition in people older than 50 years of age. In advanced stage of this disease, integrated care (IC) is recommended as an optimal approach. IC allows for holistic and patient-focused care carried out at the patient’s home. The aim of this study was to analyze the impact of IC on costs of care and on demand for medical services among patients included in IC.
MATERIAL AND METHODS: The study included 154 patients diagnosed with advanced COPD. Costs of care (general, COPD, and exacerbations-related) were evaluated for 1 year, including 6-months before and after implementing IC. The analysis included assessment of the number of medical procedures of various types before and after entering IC and changes in medical services providers.
RESULTS: Direct medical costs of standard care in advanced COPD were 886.78 EUR per 6 months. Costs of care of all types decreased after introducing IC. Changes in COPD and exacerbation-related costs were statistically significant (p=0.012492 and p=0.017023, respectively). Patients less frequently used medical services for respiratory system and cardiovascular diseases. Similarly, the number of hospitalizations and visits to emergency medicine departments decreased (by 40.24% and 8.5%, respectively). The number of GP visits increased after introducing IC (by 7.14%).
CONCLUSIONS: The high costs of care in advanced COPD indicate the need for new forms of effective care. IC caused a decrease in costs and in the number of hospitalization, with a simultaneous increase in the number of GP visits.