Evaluation of the COPDnet integrated care model in patients with COPD: the study protocol

• Published in: International journal of chronic obstructive pulmonary disease 2018-01, Vol.13, p.2237-2244
• Main Authors: Koolen, Eleonore H, van der Wees, Philip J, Westert, Gert P, Dekhuijzen, Richard, Heijdra, Yvonne F, van 't Hul, Alex J
• Format: Article
• Language: English
• Subjects: Airway management; Analysis; Care and treatment; chronic care model; Chronic illnesses; Chronic obstructive lung disease; Chronic obstructive pulmonary disease; COPD; COPD management; Costs; Data collection; Delivery of Health Care, Integrated - economics; Delivery of Health Care, Integrated - methods; Disease management; Evidence-Based Medicine; Feasibility Studies; General practitioners; Health aspects; Health Care Costs; Health care policy; Health Plan Implementation - methods; Health Status; Hospitals; Humans; integrated care; Integrated delivery systems; Interviews; Medical personnel; Medical research; Morbidity; Mortality; Netherlands; Nurse specialists; Outpatient care facilities; Patients; Primary care; Primary Health Care; Professionals; Prospective Studies; Pulmonary Disease, Chronic Obstructive - diagnosis; Pulmonary Disease, Chronic Obstructive - therapy; Questionnaires; Retirement benefits; Study Protocol
• ISSN: 1178-2005; 1176-9106; 1178-2005
• DOI: 10.2147/COPD.S153992

Projections on the future suggest a further rise in the prevalence of patients with COPD, and in COPD related morbidity, mortality, and health care costs worldwide. Given the substantial impact on the individual and on society, it is important to establish a care process that maximizes outcomes in relation to the costs and efforts made. In an attempt to bridge this gap, we set out to develop an evidence-based model of integrated care for patients with COPD, named the COPDnet integrated care model. The current study protocol sets out to 1) evaluate the feasibility of employing the COPDnet model in present real-life care within the context of the Dutch health care system, 2) explore the potential health status benefits, and 3) analyze the costs of care of this model. In this prospective study, feasibility and health status changes will be evaluated with an experimental before and after study design. The costs of the diagnostic trajectory will be calculated according to a standard economic health care evaluation approach. Furthermore, the feasibility and cost of care studies will comprise both quantitative and qualitative data collection. For the studies on the feasibility and change in health status, all new patients qualifying for shared care by primary and secondary care professionals according to the Dutch Standard of Care for COPD, and patients referred by their general practitioners to one of the COPDnet hospitals will be included. To evaluate the feasibility and costs of care, semi-structured interviews will be held with patients, hospital personnel, health care professionals in the affiliated primary care region, and hospital and primary care group managers. The COPDnet integrated care model for COPD patients has been designed according to the current insights regarding effective care for patients with a chronic condition in general, and for patients with COPD in particular. It will be evaluated for its feasibility, potential health status benefits, and the costs of care of the diagnostic trajectory in secondary care.