Comprehensive care plans for patients with Chronic Obstructive Pulmonary Disease (COPD): Effect on health services utilization

Figures & data

Table 1. Characteristic of study population: qualifying conditions, comorbidity burden, and demographics.

Characteristic	Total (N = 88,002)	Matched controls (N = 52,155)	CACP cohort (N = 35,847)	p Value^a
Sex, N (%)
Female	41,436 (47)	24,578 (47)	16,858 (47)	.7764
Male	46,566 (53)	27,577 (53)	18,989 (53)
Age, mean (SD), years	66 (12)	67 (13)	65 (12)	<.0001
Qualifying Conditions, N (%)
Hypertension	45,737 (52.0)	26,498 (51.0)	19,239 (54.0)	<.0001
Diabetes Mellitus	16,463 (19.0)	9290 (18.0)	7173 (20.0)	<.0001
Asthma	11,687 (13.0)	6738 (13.0)	4949 (14.0)	<.0001
Chronic Heart Failure	2914 (3.3)	1665 (3.2)	1249 (3.5)	.0174
Ischemic Heart Disease	10,915 (12.0)	6245 (12.0)	4670 (1.03)	<.0001
Mental Health Disorder	40,550 (46.0)	24,337 (47.0)	16,213 (45.0)	<.0001
Obesity	165,568 (18.0)	9015 (17.0)	6553 (18.0)	<.0001
Addiction	1700 (1.9)	1019 (2.0)	681 (1.9)	.5671
Tobacco	26,945 (31.0)	16,308 (31.0)	10,637 (30.0)	<.0001
Baseline Elixhauser Score, mean (SD)	0.16 (0.41)	0.20 (0.46)	0.088 (0.30)	<.0001

Abbreviations: CACP, comprehensive annual care plan.

^at Tests and chi-square tests.

Figure 1. Difference and overall trend in mean monthly COPD-related hospitalizations per 10,000 patients in CACP group compared to Control group. Abbreviations: CACP, comprehensive annual care plan; COPD, chronic obstructive pulmonary disease.

Table 2. Interrupted time series analysis of healthcare utilization before and after CACP in COPD patients (1 year pre- and post-CACP index date) per 10,000 patients.

Outcome	Difference in outcome (CACP group vs Control group)
	Intercept 12 months before index date	Pre-incentive trend	Immediate/level change		Temporal/trend change	Overall effect
			β1, (CI)	p Value	β2, (CI)	p Value	Absolute diff (CI)
COPD hospitalizations	−127.24(−142.04-−112.44)	−4.73(−7.24-−2.22)	25.71(4.13-47.3)	.0196	6.63(3.79-9.48)	<.0001	105.33(58.17-152.49)
COPD ED visits	−136.38(−136.4-−136.35)	−6.79(−6.80-−6.79)	77.75(68.59-86.91)	<.0001	7.91(6.76-9.05)	<.0001	172.65(168.09-177.20)
COPD GP visits	−77.56(−82.2-−72.92)	−7.82(−12.45-−3.19)	251.29(200.01-302.56)	<.0001	9.02(2.57-15.47)	.0062	359.53(247.64-471.41)
COPD specialist visits	15.69(−145.31-176.69)	−2.53(−4.29-−0.76)	57.24(22.64-91.85)	.0012	1.66(−1.88-5.21)	.3578	77.21(31.58-122.85)
COPD RM visits	−9.56(−15.64-−3.48)	−1.84(−2.74-−0.94)	33.15(23.96-42.33)	<.0001	1.65(0.38-2.92)	.0200	52.96(35.75-70.18)
PFTs	−10.44(−17.8-−3.09)	−1.48(−2.40-−0.55)	61.39(49.91-72.87)	<.0001	−0.88(−2.26-0.50)	.2119	50.82(35.33-66.30)

Abbreviations: CACP, comprehensive annual care plan; CI, confidence interval; COPD, chronic obstructive pulmonary disease; ED, emergency department; GP, general practitioner; PFT, pulmonary function test; RM, respiratory medicine.

Figure 2. Difference and overall trend in mean monthly COPD-related ED visits per 10,000 patients in CACP group compared to Control group. Abbreviations: CACP, comprehensive annual care plan; COPD, chronic obstructive pulmonary disease.

Data availability statement

The dataset from this study is held securely in coded form at the School of Public Health, University of Alberta. Access may be granted to those who meet pre-specified criteria for confidential access.