title: The effect of rehabilitation on health-care utilisation in COPD patients in Copenhagen.
abstract: BACKGROUND
  The Integrated Rehabilitation Programme for Chronic Conditions project (SIKS) implemented rehabilitation programmes for people with four chronic conditions in the local area within the Municipality of Copenhagen.
  
  
  OBJECTIVE
  The objective of this study was to evaluate the impact of rehabilitation on health-care utilisation in chronic obstructive pulmonary disease (COPD) patients as a subgroup of SIKS.
  
  
  METHODS
  For the analyses, data from Danish National Registers' were obtained. The following outcomes were analysed: (i) COPD hospital admissions, (ii) COPD bed days, (iii) COPD outpatient visits, (iv) COPD emergency room visits, (v) general practitioner visits, (vi) specialist visits, and (vii) COPD specific medication. The rehabilitation group consisted of 118 patients who completed the programme. The control group consisted of 236 COPD patients in Copenhagen who did not undergo rehabilitation and were matched with the intervention group according to propensity score calculated on the basis of patient socio-demographic characteristics and health-care utilisation pattern in 2 years prior to the rehabilitation programme. The effect was assessed by applying the principle of difference-in-difference analysis.
  
  
  RESULTS
  Compared with their matched controls, the patients participating in the rehabilitation programme showed a statistically significantly smaller increase in hospital admissions, bed days and outpatient visits.
  
  
  CONCLUSIONS
  The study provides the policy decision makers in the Municipality of Copenhagen with an assessment of the effect of a real-life intervention. It shows that the pulmonary rehabilitation programme introduced had the anticipated effects on health-care utilisation. The study also suggests that the methods used for evaluation were appropriate.
authors.affiliation: Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospital, Capital Region, Denmark.
authors.forename: Ramune
authors.initials: R
authors.lastname: Jacobsen
authors.forename: Ea
authors.initials: E
authors.lastname: Rusch
authors.forename: Per Kragh
authors.initials: PK
authors.lastname: Andersen
authors.forename: John
authors.initials: J
authors.lastname: Adams
authors.forename: Cecilia Ravn
authors.initials: CR
authors.lastname: Jensen
authors.forename: Anne
authors.initials: A
authors.lastname: Frølich
mesh_terms: D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D016022:Case-Control Studies; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D010343:Patient Admission / Q000706:statistics & numerical data*; D015397:Program Evaluation; D057216:Propensity Score; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology / Q000534:rehabilitation*; D012042:Registries
keywords: COPD; hospital admissions; outcome assessment; rehabilitation