title: The effectiveness of coordinated care for people with chronic respiratory disease.
abstract: OBJECTIVE
  To evaluate the effectiveness of coordinated care for chronic respiratory disease.
  
  
  METHODS
  Community-based geographical control study, in western (intervention) and northern (comparison) metropolitan Adelaide (SA).
  
  
  METHODS
  377 adults (223 intervention; 154 comparison) with chronic obstructive pulmonary disease, asthma or other chronic respiratory condition, July 1997 to December 1999.
  
  
  METHODS
  Coordinated care (includes care coordinator, care guidelines, service coordinator and care mentor).
  
  
  METHODS
  Hospital admissions (any, unplanned and respiratory), functionality (activities of daily living) and quality of life (SF-36 and Dartmouth COOP).
  
  
  RESULTS
  At entry to the study, intervention and comparison subjects were dissimilar. The intervention group was 10 years older (P < 0.001), less likely to smoke (P = 0.014), had higher rates of hospitalisation in the previous 12 months (P < 0.001) and had worse self-reported quality of life (SF-36 physical component summary score [P < 0.001] and four of nine COOP domains [P = 0.002-0.013]). After adjustment for relevant baseline characteristics, coordinated care was not associated with any difference in hospitalisation, but was associated with some improvements in quality of life (SF-36 mental component summary score [P = 0.023] and three of nine COOP domains [P = 0.008-0.031]) compared with the comparison group.
  
  
  CONCLUSIONS
  Coordinated care given to patients with chronic respiratory disease did not affect hospitalisation, but it was associated with an improvement in some quality-of-life measures.
authors.affiliation: The Queen Elizabeth Hospital, 28 Woodville Road, Woodville, Adelaide, SA 5011, Australia. brian.smith@nwahs.sa.gov.au
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Smith
authors.forename: Heather J
authors.initials: HJ
authors.lastname: McElroy
authors.forename: Richard E
authors.initials: RE
authors.lastname: Ruffin
authors.forename: Peter A
authors.initials: PA
authors.lastname: Frith
authors.forename: Adrian R
authors.initials: AR
authors.lastname: Heard
authors.forename: Malcolm W
authors.initials: MW
authors.lastname: Battersby
authors.forename: Adrian J
authors.initials: AJ
authors.lastname: Esterman
authors.forename: Peter
authors.initials: P
authors.lastname: Del Fante
authors.forename: Peter J
authors.initials: PJ
authors.lastname: McDonald
mesh_terms: D000203:Activities of Daily Living; D002908:Chronic Disease; D003191:Comprehensive Health Care / Q000191:economics / Q000458:organization & administration*; D005260:Female; D017048:Health Care Costs; D006296:Health Services / Q000706:statistics & numerical data; D006304:Health Status; D006760:Hospitalization; D006801:Humans; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D010348:Patient Care Team; D016016:Proportional Hazards Models; D011788:Quality of Life; D012140:Respiratory Tract Diseases / Q000191:economics / Q000628:therapy*; D013021:South Australia; D016896:Treatment Outcome