title: Evaluation of a regional disease management programme for patients with asthma or chronic obstructive pulmonary disease.
abstract: 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.
authors.affiliation: Department of Health Care Studies, Maastricht University, Maastricht, the Netherlands. l.steuten@zw.unimaas.nl
authors.forename: Lotte
authors.initials: L
authors.lastname: Steuten
authors.forename: Bert
authors.initials: B
authors.lastname: Vrijhoef
authors.forename: Frits
authors.initials: F
authors.lastname: Van  Merode
authors.forename: Geert-Jan
authors.initials: GJ
authors.lastname: Wesseling
authors.forename: Cor
authors.initials: C
authors.lastname: Spreeuwenberg
mesh_terms: 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