title: Long-term Effect of Home Nursing Intervention on Cost and Healthcare Utilization for Patients with Chronic Obstructive Pulmonary Disease: A Retrospective Observational Study.
abstract: OBJECTIVE
  The present study aimed to examine the long-term effects of a home nursing intervention on healthcare utilization and costs among patients with chronic obstructive pulmonary disease (COPD).
  
  
  METHODS
  A 3-year retrospective study.
  
  
  METHODS
  Eleven COPD patients who had received home nursing intervention after hospital discharge were enrolled. We retrospectively investigated their healthcare utilization and costs for 1 year before the intervention and during 2 years of the intervention.
  
  
  RESULTS
  The number and length of hospitalizations decreased gradually from the pre-intervention period through the second year. The number of hospital and home nursing visits increased from the pre-intervention period through the first and second years. The hospitalization costs were decreased by approximately half from the pre-intervention period through the first year and from the first year through the second year. The total medical cost did not change significantly.
  
  
  CONCLUSIONS
  Our home nursing intervention decreased the number and length of hospitalizations and the hospitalization costs; however, it did not affect the total medical cost. It is possible that the continuation of home nursing interventions may decrease the number of hospitalizations, number of home nursing visits, and the total medical cost by maintaining the health condition of patients.
authors.affiliation: Department of Community Health Sciences, Kobe University Graduate School of Health Sciences, Kobe, Japan.
authors.forename: Takuro
authors.initials: T
authors.lastname: Matsumura
authors.affiliation: Department of Rehabilitation, Seihoukai Oyama Hospital, Nishiwaki, Japan.
authors.forename: Kana
authors.initials: K
authors.lastname: Takarada
authors.affiliation: Department of Community Health Sciences, Kobe University Graduate School of Health Sciences, Kobe, Japan.
authors.forename: Yutaro
authors.initials: Y
authors.lastname: Oki
authors.affiliation: Department of Community Health Sciences, Kobe University Graduate School of Health Sciences, Kobe, Japan.
authors.forename: Yukari
authors.initials: Y
authors.lastname: Fujimoto
authors.affiliation: Home-visit Nursing Station Wakakusa, Nagano, Japan.
authors.forename: Hiromi
authors.initials: H
authors.lastname: Kaneko
authors.affiliation: National Hospital Organization Higashi Nagano Hospital, Nagano, Japan.
authors.forename: Mineko
authors.initials: M
authors.lastname: Ohira
authors.affiliation: Department of Community Health Sciences, Kobe University Graduate School of Health Sciences, Kobe, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Ishikawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003362:Cost-Benefit Analysis; D005260:Female; D006701:Home Nursing / Q000191:economics*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007564:Japan; D008297:Male; D010351:Patient Discharge / Q000191:economics*; D029424:Pulmonary Disease, Chronic Obstructive / Q000191:economics* / Q000534:rehabilitation*; D019145:Rehabilitation Nursing / Q000191:economics*; D012189:Retrospective Studies
keywords: Chronic obstructive pulmonary disease; cost; healthcare utilization; home nursing; hospitalization