Estimating the Health and Economic Impact of Improved Management in Prevalent Chronic Obstructive Pulmonary Disease Populations in England, Germany, Canada, and Japan: A Modelling Study.
Int J Chron Obstruct Pulmon Dis
; 18: 2127-2146, 2023.
Article
in En
| MEDLINE
| ID: mdl-37789931
ABSTRACT
Introduction:
COPD is a leading cause of morbidity and mortality globally. Management is complex and costly. Although international quality standards for diagnosis and management exist, opportunities remain to improve outcomes, especially in reducing avoidable hospitalisations.Objective:
To estimate the potential health and economic impact of improved adherence to guideline-recommended care for prevalent, on-treatment COPD populations in four high-income settings.Methods:
A disease simulation model was developed to evaluate the impact of theoretical improvements to COPD management, comparing outcomes for usual care and policy scenarios for interventions that reduce avoidable hospitalisations 1) increased attendance (50% vs 31-38%) of early follow-up review after severe exacerbation hospitalisation; 2) increased access (30% vs 5-10%) to an integrated disease management (IDM) programme that provides guideline adherent care.Results:
For cohorts of 100,000 patients, Policy 1 yielded additional life years (England 523; Germany 759; Canada 1316; Japan 512) and lifetime cost savings (-£2.89 million; -6.58 million; -$40.08 million; -¥735.58 million). For Policy 2, additional life years (2299; 3619; 3656) and higher lifetime total costs (£38.15 million; 35.58 million; ¥1091.53 million) were estimated in England, Germany and Japan, and additional life years (4299) and cost savings (-$20.52 million) in Canada. Scenarios found that the cost impact depended on the modelled intervention effect size.Conclusion:
Interventions that reduce avoidable hospitalisations are estimated to improve survival and may generate cost savings. This study provides evidence on the theoretical impact of policies to improve COPD care and highlights priority areas for further research to support evidence-based policy decisions.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Pulmonary Disease, Chronic Obstructive
Type of study:
Guideline
/
Health_economic_evaluation
/
Prognostic_studies
Aspects:
Patient_preference
Limits:
Humans
Country/Region as subject:
America do norte
/
Asia
/
Europa
Language:
En
Journal:
Int J Chron Obstruct Pulmon Dis
Year:
2023
Document type:
Article
Affiliation country:
Reino Unido