1 Section of Biostatistics, Department of Public Health, Faculty of Health and Medical Sciences, Københavns Universitet2 Department of Public Health, Department of Public Health, Faculty of Health and Medical Sciences, Københavns Universitet3 unknown4 Graduate School of Health and Medical Sciences, Faculty of Health and Medical Sciences, Københavns Universitet5 Section of Biostatistics, Department of Public Health, Faculty of Health and Medical Sciences, Københavns Universitet6 Graduate School of Health and Medical Sciences, Faculty of Health and Medical Sciences, Københavns Universitet
INTRODUCTION: The Integrated Rehabilitation Programme for Chronic Conditions project (SIKS) implemented rehabilitation programmes for people with four chronic conditions in the local area within the Municipality of Copenhagen. OBJECTIVES: The objective of this study was to evaluate the impact of rehabilitation on health-care utilisation in chronic obstructive pulmonary disease (COPD) patients as a subgroup of SIKS. METHODS: For the analyses, data from Danish National Registers' were obtained. The following outcomes were analysed: (i) COPD hospital admissions, (ii) COPD bed days, (iii) COPD outpatient visits, (iv) COPD emergency room visits, (v) general practitioner visits, (vi) specialist visits, and (vii) COPD specific medication. The rehabilitation group consisted of 118 patients who completed the programme. The control group consisted of 236 COPD patients in Copenhagen who did not undergo rehabilitation and were matched with the intervention group according to propensity score calculated on the basis of patient socio-demographic characteristics and health-care utilisation pattern in 2 years prior to the rehabilitation programme. The effect was assessed by applying the principle of difference-in-difference analysis. RESULTS: Compared with their matched controls, the patients participating in the rehabilitation programme showed a statistically significantly smaller increase in hospital admissions, bed days and outpatient visits. CONCLUSIONS: The study provides the policy decision makers in the Municipality of Copenhagen with an assessment of the effect of a real-life intervention. It shows that the pulmonary rehabilitation programme introduced had the anticipated effects on health-care utilisation. The study also suggests that the methods used for evaluation were appropriate.
Clinical Respiratory Journal, 2014, Vol 8, Issue 3, p. 321-9
Aged; Ambulatory Care; Case-Control Studies; Denmark; Female; Humans; Length of Stay; Male; Patient Admission; Program Evaluation; Propensity Score; Pulmonary Disease, Chronic Obstructive; Registries; Journal Article; Research Support, Non-U.S. Gov't