TY - JOUR T1 - Costs and effects of structured COPD care - An observational, matched-cohort study JF - European Respiratory Journal JO - Eur Respir J VL - 42 IS - Suppl 57 SP - P2418 AU - Karin Lisspers AU - Gunnar Johansson AU - Christer Jansson AU - Georgios Stratelis AU - Leif Jörgensen AU - Kjell Larsson AU - Morten Hedegaard AU - Björn Ställberg Y1 - 2013/09/01 UR - http://erj.ersjournals.com/content/42/Suppl_57/P2418.abstract N2 - RationaleCOPD guidelines emphasise the importance of patient education to improve treatment and avoid exacerbations. Studies evaluating the importance of structured management of COPD in primary care are scarce. The effectiveness of the availability of an asthma/COPD clinic in primary care with regard to exacerbations and costs was investigated.MethodsResource use and exacerbation data regarding 21,361 patients at 76 primary healthcare centres (PHCCs) were collected and linked with hospital, drug and cause of death data (1999–2009) from national mandatory Swedish registries (NCT01146392). Exacerbations were defined as COPD-related hospitalisations, ER visits, and oral steroid or antibiotic prescriptions. Healthcare structure was reported by questionnaire.Propensity score matching at index date (first COPD diagnosis) was used to compensate for non-random assignment of patients to centres with or without an asthma/COPD clinic. Difference in exacerbation rates was tested with Poisson regression. Swedish unit costs were applied to the annual resource use to calculate annual costs per patient.ResultsPatients treated at PHCCs with asthma/COPD clinics had significantly fewer exacerbations relative to patients managed at PHCCs without an asthma/COPD clinic (0.71 vs. 0.98, 27% difference, NNT 3.7, p<0.0001). Having an asthma/COPD clinic reduced the annual cost of medication and healthcare contacts from SEK 52,892 (€5858) to SEK 33,410 (€3700) per patient, a reduction of 37% (SEK 19,482 [€2158]).ConclusionThis study found that patients managed at PHCCs having an asthma/COPD clinic had fewer exacerbations and that structured care substantially reduced treatment costs for patients with COPD.FundingAstraZeneca. ER -