title: How integrated are services for patients with chronic obstructive pulmonary disease? Perceptions of patients and health care providers.
abstract: Chronic obstructive pulmonary disease (COPD) is a common cause of hospital readmissions worldwide. Outcomes for COPD patients improve if care is more integrated. COPD patients and their health care providers at a district hospital and community health service were interviewed about their perceptions of integration of care. Patients were confused about provider roles, had little understanding of their disease, had difficulty accessing services and did not have COPD action plans. Health care providers espoused integration of COPD care. Care was reasonably well integrated in the hospital. Integration of care was compromised in the community because COPD patients went to the emergency department when symptoms became unmanageable, while only attending their GPs for routine booked appointments. Integration could be improved if health care providers spent more time with patients, promoting understanding of the disease, supporting self-management and liaising with other providers. Patients would benefit from an action plan and additional support. Potentially preventable COPD admissions will continue without action to improve integration of community services and patients' understanding of their condition.
authors.affiliation: Centre for Primary Health Care and Equity, University of New South Wales, UNSW Sydney, NSW 2052, Australia.
authors.forename: S E
authors.initials: SE
authors.lastname: Kirby
authors.affiliation: Prairiewood Community Health, South Western Sydney Local Health District, Locked Bag 7279, Liverpool BC 187, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Mutimbe
authors.affiliation: General Practice Unit, Fairfield Hospital, PO Box 6732, Wetherill Park DC, NSW 1851, Australia.
authors.forename: S
authors.initials: S
authors.lastname: Vagholkar
authors.affiliation: General Practice Unit, Fairfield Hospital, PO Box 6732, Wetherill Park DC, NSW 1851, Australia.
authors.forename: J
authors.initials: J
authors.lastname: Bunker
authors.affiliation: Centre for Primary Health Care and Equity, University of New South Wales, UNSW Sydney, NSW 2052, Australia.
authors.forename: S M
authors.initials: SM
authors.lastname: Dennis
authors.affiliation: Centre for Primary Health Care and Equity, University of New South Wales, UNSW Sydney, NSW 2052, Australia.
authors.forename: S-T
authors.initials: ST
authors.lastname: Liaw
mesh_terms: D001291:Attitude of Health Personnel; D001294:Attitude to Health; D019090:Case Management; D002908:Chronic Disease; D003153:Community Health Services; D019033:Delivery of Health Care, Integrated / Q000379:methods*; D006297:Health Services Accessibility; D006767:Hospitals, District; D006801:Humans; D007407:Interviews as Topic / Q000379:methods; D017060:Patient Satisfaction; D010819:Physician's Role; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy*