title: Cost-effectiveness of 'Program We Care' for patients with chronic obstructive pulmonary disease: A case-control study.
abstract: OBJECTIVE
  To evaluate the effectiveness of a discharge program for patients with chronic obstructive pulmonary disease (COPD) patients on discharge from an emergency medical ward on discharge home rate, hospital length of stay (LOS), inpatient admission rate and cost.
  
  
  BACKGROUND
  Frequent visits to the emergency department (ED) and subsequent hospital admission are common among patients with COPD, which adds a burden to ED and hospital care. A discharge program was implemented in an ED emergency medical ward. The program consisted of multidisciplinary care, discharge planning, discharge health education on disease management, and continued support from the community nursing services.
  
  
  METHODS
  A retrospective case-control study was used. Data were retrieved and compared between 478 COPD program cases and 478 COPD non-program cases.
  
  
  RESULTS
  No significant difference was found in age, gender, and triage category, LOS in ED, and readmission rate between the program and non-program groups. The program group demonstrated a significantly higher discharge home rate from the ED (33.89% vs. 20.08%) and fewer medical admissions (40.59% vs. 55.02%) compared with the non-program group, resulting in lower total medical costs after the program was implemented.
  
  
  CONCLUSIONS
  The program provides insight on the strategic planning for discharge care in a short stay unit of emergency department.
authors.affiliation: The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong. Electronic address: elizawong@cuhk.edu.hk.
authors.forename: Eliza Mi Ling
authors.initials: EM
authors.lastname: Wong
authors.affiliation: Emergency Department, Alice Ho Miu Ling Nethersole Hospital, HKSAR, China.
authors.forename: Shuk Man
authors.initials: SM
authors.lastname: Lo
authors.affiliation: Department of Economics, School of Business, Hong Kong Baptist University, HKSAR, China.
authors.forename: Ying Chu
authors.initials: YC
authors.lastname: Ng
authors.affiliation: Emergency Department, Alice Ho Miu Ling Nethersole Hospital, HKSAR, China.
authors.forename: Larry Lap Yip
authors.initials: LL
authors.lastname: Lee
authors.affiliation: Emergency Department, Alice Ho Miu Ling Nethersole Hospital, HKSAR, China.
authors.forename: T M Y
authors.initials: TM
authors.lastname: Yuen
authors.affiliation: Emergency Department, Alice Ho Miu Ling Nethersole Hospital, HKSAR, China.
authors.forename: Jimmy Tak Shing
authors.initials: JT
authors.lastname: Chan
authors.affiliation: The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong.
authors.forename: Sek Ying
authors.initials: SY
authors.lastname: Chair
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003365:Costs and Cost Analysis / Q000379:methods*; D005260:Female; D006723:Hong Kong; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000191:economics*; D015397:Program Evaluation / Q000379:methods*; D029424:Pulmonary Disease, Chronic Obstructive / Q000191:economics* / Q000628:therapy*; D012189:Retrospective Studies
keywords: Admission; Chronic obstructive pulmonary disease; Cost-effectiveness; Discharge program; Emergency department; Medical ward