Source: Annual Congress 2011 - Exacerbations and severe chronic respiratory disease: oxygen, rehabilitation, admission to hospital and palliative care
Disease area: Airway diseases

Abstract

Background: It was estimated that the prevalence of COPD among the elderly Chinese living in Hong Kong was 25.9%.
Methods: The COAD Alliance Community Program was designed and carried out by a community hospital in Hong Kong. It involves a multidisciplinary team of specialists via a community outreach approach. The highly dedicated team includes respiratory physicians, physiotherapists, occupational therapists, community outreach nurses, and other community based specialists. High risk patients with more than 3 emergency room or hospital admissions per year were identified and recruited into the program. They were then assessed by case managers who were responsible organizing the community based services for these patients. Services provided include advice and information provision, self care management at home, outreach nursing visits, outpatient physiotherapy sessions and emotional/counseling support. These patients‘ "pre - program" and "post - program" emergency room admission rates, inpatient admissions and hospital inpatient bed-days were recorded and tabulated.
Results: 100 patients were recruited into the COPD Alliance Community Program. Six patients died during this period, with 94 patients remaining for analysis. Reduction in AED attendance (mean number of admission of 2.38 pre program c.f 1.68 post program) and medical ward admissions (1.6 c.f 0.85) was evident. There is also a significant reduction in hospital inpatient bed-days (8.16 days pre program c.f. 4.42 days post program, p = 0.05). Total cost reduction is 215,028 Euros.
Conclusion: The multidisciplinary approach was effective in reducing emergency room attendances, inpatient bed –days and total health expenditure.

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D. Liu, K.M Lo, Y.H Leung, H.M Ma, H.S Chan, S. S. Ho (Hong Kong, Hong Kong). Promoting excellence in COAD care – Through a community multidisciplinary team approach. Eur Respir J 2011; 38: Suppl. 55, 1251

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