Effectiveness of Healthcare Coordination in Patients with Chronic Respiratory Diseases

Adv Exp Med Biol. 2018:1040:47-62. doi: 10.1007/5584_2017_84.

Abstract

Coordination of healthcare effectively prevents exacerbations and reduces the number of hospitalizations, emergency visits, and the mortality rate in patients with chronic respiratory diseases. The purpose of this study was to determine clinical effectiveness of ambulatory healthcare coordination in chronic respiratory patients and its effect on the level of healthcare services as an indicator of direct medical costs. We conducted a retrospective health record survey, using an online database of 550 patients with chronic respiratory diseases. There were decreases in breathing rate, heart rate, and the number of cigarettes smoked per day, and forced vital capacity (FVC) and forced expired volume in 1 s (FEV1) increased after the implementation of the coordinated healthcare structure. These benefits were accompanied by increases in the number of visits to the pulmonary outpatient clinic (p < 0.001), diagnostic costs (p < 0.001), and referrals to other outpatient clinics (p < 0.003) and hospitals (p < 0.001). The advantageous effects of healthcare coordination on clinical status of respiratory patients above outlined persisted over a 3-year period being reviewed.

Keywords: Chronic diseases; General practice; Healthcare; Healthcare expenditure; Healthcare programs; Healthcare services; Respiratory Tract Diseases.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Databases, Factual
  • Disease Progression
  • Female
  • Health Care Surveys
  • Health Expenditures*
  • Humans
  • Lung / physiopathology*
  • Male
  • Middle Aged
  • Patient Care Team / economics*
  • Poland
  • Respiration Disorders / economics
  • Respiration Disorders / physiopathology
  • Respiration Disorders / therapy*
  • Respiratory Function Tests
  • Retrospective Studies
  • Young Adult