The effectiveness of coordinated care for people with chronic respiratory disease.
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.
Smith
Brian J
BJ
The Queen Elizabeth Hospital, 28 Woodville Road, Woodville, Adelaide, SA 5011, Australia. brian.smith@nwahs.sa.gov.au
McElroy
Heather J
HJ
Ruffin
Richard E
RE
Frith
Peter A
PA
Heard
Adrian R
AR
Battersby
Malcolm W
MW
Esterman
Adrian J
AJ
Del Fante
Peter
P
McDonald
Peter J
PJ
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