Evaluation of a regional disease management programme for patients with asthma or chronic obstructive pulmonary disease.
OBJECTIVE
To assess the impact of a population-based disease management programme for adult patients with asthma or chronic obstructive pulmonary disease (COPD) on process measures, intermediate outcomes, and endpoints of care.


METHODS
Quasi-experimental design with 12-month follow-up.


METHODS
Region of Maastricht (the Netherlands) including university hospital and 16 general practices.


METHODS
Nine hundred and seventy-five patients of whom 658 have asthma and 317 COPD.


METHODS
Disease management programme.


METHODS
Endpoints of care are respiratory health, health utility, patient satisfaction, and total health care costs related to asthma or COPD.


RESULTS
Quality aspects of care, disease control, self-care behaviour, smoking status, disease-specific knowledge, and patients' satisfaction improved after implementation of the programme. Lung function was not affected by implementation of the programme. For COPD patients, a significant improvement in health utility was found. For patients with asthma, significant cost savings were measured.


CONCLUSIONS
Organizing health care according to principles of disease management for adults with asthma or COPD is associated with significant improvements in several processes and outcomes of care, while costs of care do not exceed the existing budget.
Steuten
Lotte
L
Department of Health Care Studies, Maastricht University, Maastricht, the Netherlands. l.steuten@zw.unimaas.nl
Vrijhoef
Bert
B
Van  Merode
Frits
F
Wesseling
Geert-Jan
GJ
Spreeuwenberg
Cor
C
D000704:Analysis of Variance; D001249:Asthma / Q000628:therapy*; D019468:Disease Management; D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D015397:Program Evaluation; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy*; D011785:Quality Assurance, Health Care; D012129:Respiratory Function Tests