TY - JOUR T1 - Integrated care reduces hospital utilization among patients with severe COPD JF - European Respiratory Journal JO - Eur Respir J VL - 44 IS - Suppl 58 SP - P529 AU - Elena Titova AU - Synnøve Sunde AU - Sigurd Steishamn AU - Anne Hildur Henriksen Y1 - 2014/09/01 UR - http://erj.ersjournals.com/content/44/Suppl_58/P529.abstract N2 - Background: It has been shown that various integrated care models (ICM) effectively improve disease control and reduce hospital admission (HA) rates in patients with chronic obstructive pulmonary disease (COPD). In Trondheim an ICM (COPD-Home) was developed in 2008 and adapted to local healthcare facilities.Aims and objectives: To determine the efficacy of the COPD-Home ICM in reducing hospital utilization among patients with severe and very severe COPD (GOLD III and IV 2010).Methods: A single centre, prospective, open, controlled clinical study comparing the COPD-Home ICM (IC) with usual care (UC). IC consists of an education program, self-management plan, home visits and a call centre for patient support and communication.Results: Eighty-six patients in the IC group (ICG) and 70 patients UC group (UCG), mean age 73.9 ± 9.2 years (56% women) were included, and after 2 years follow-up 51 and 49 patients in the respective groups were available for control. During the year prior to inclusion the number of hospital admissions (HA) for acute COPD exacerbation or pneumonia was 67 and 79 in the ICG and UCG respectively. After 1 year the change in HA rates was -53.7% in the ICG and 0% in the UCG (P= 0.08). After 2 years the change in HA rates was still -44.7% in the ICG compared to +13.9% in the UCG (P=0.01). The number of in-hospital days followed the same pattern as HA rates in both groups. There was a trend towards a shorter survival time among patients in the ICG compared to the UCG, hazard ratio 1.48 [95% CI 0.85 to 2.58].Conclusion: The COPD-Home ICM reduced hospital utilization in patients with COPD III and IV with a persisting effect throughout the 2 year follow-up period. ER -