Reducing Health Care Resource Utilization in COPD: A Retrospective Matched Control Analysis of a Digital Quality Improvement Program.

ABSTRACT

Introduction: Chronic obstructive pulmonary disease (COPD) is a progressive lung disease that adds a significant economic burden to the health care system in the United States. Digital platforms integrated into clinical workflows have demonstrated success in improving patient outcomes in COPD, but few studies have explored the impact of an integrated digital and clinical approach on drivers of direct health care costs (COPD-related prescriptions, emergency department [ED] visits, and hospitalizations) in a real-world setting. Methods: We conducted a 6-month retrospective matched control analysis to assess the impact of a digital quality improvement (QI) program delivered by clinical pharmacists on health care resource utilization among people living with COPD. Results: Compared to matched controls at 6 months, participants in the digital QI program had a 66.7% relative reduction in COPD-related ED visits and hospitalizations (0.04±0.19 versus 0.12±0.44, p=0.044), as well as a 47% reduction in all-cause ED visits and hospitalizations (0.25±0.63 versus 0.47±1.09, p=0.059). Participants in the digital QI program also had higher rates of COPD-related prescription fills for antibiotics (0.43±0.93 versus 0.35±0.74, p=0.881) and oral corticosteroids (0.56±1.02 versus 0.36±0.91, p=0.045), as well as a greater number of COPD-related nonacute urgent care visits compared to matched controls (0.3±0.63 versus 0.14±0.44, p=0.027). Conclusion: Digital health platforms integrated into a virtual clinical pharmacist workflow can help reduce costly COPD-related ED visits and hospitalizations, and shift utilization to less acute care. Care models integrating digital platforms may also offer a scalable approach to managing COPD and should be explored in different clinical settings.