Cost-effectiveness of 'Program We Care' for patients with chronic obstructive pulmonary disease: A case-control study

- A retrospective case control design was used to compare two cohorts of patients with chronic obstructive pulmonary disease.
- Compared the outcomes of medical admission, discharge home rate and cost.
- A significantly higher discharge home rate in program cohort.
- Significantly fewer medical admissions and a lower cost for the program cohort.
- This discharge program was feasible to conduct in an emergency department.

ObjectivesTo evaluate the effectiveness of a discharge program for patients with chronic obstructive pulmonary disease (COPD) patients on discharge from an emergency medical ward on discharge home rate, hospital length of stay (LOS), inpatient admission rate and cost.BackgroundFrequent visits to the emergency department (ED) and subsequent hospital admission are common among patients with COPD, which adds a burden to ED and hospital care. A discharge program was implemented in an ED emergency medical ward. The program consisted of multidisciplinary care, discharge planning, discharge health education on disease management, and continued support from the community nursing services.MethodsA retrospective case-control study was used. Data were retrieved and compared between 478 COPD program cases and 478 COPD non-program cases.ResultsNo significant difference was found in age, gender, and triage category, LOS in ED, and readmission rate between the program and non-program groups. The program group demonstrated a significantly higher discharge home rate from the ED (33.89% vs. 20.08%) and fewer medical admissions (40.59% vs. 55.02%) compared with the non-program group, resulting in lower total medical costs after the program was implemented.ConclusionThe program provides insight on the strategic planning for discharge care in a short stay unit of emergency department.