Development of an integrated chronic obstructive pulmonary disease service model in an inner-city region in the UK: initial findings and 12-month results

Abstract

Aims:

To improve the management of chronic obstructive pulmonary disease (COPD) in Salford, UK, and to evaluate the impact of an integrated service model after one year.

Methods:

A health needs analysis and benchmarking exercise was undertaken in 2007. These activities were used to develop an integrated service model in order to improve the diagnosis and management of COPD and reduce unscheduled hospital admissions and length of stay.

Results:

Following implementation of the model, 811 further patients were diagnosed. Unscheduled hospital admissions for COPD fell from 935 to 840, length of stay was reduced from 8.3 to 7.7 days, and associated costs fell from £1,772, 865 to £1,528,080. The number of patients who completed pulmonary rehabilitation increased from 84 to 143.

Conclusions:

An integrated COPD service model was successful in increasing diagnosis, reducing hospital admissions and reducing length of hospital stay — in line with the proposed National Strategy for COPD Services in England. It also promoted management according to National Institute of Health and Clinical Excellence (NICE) guidelines.