Effect of a hospital outreach intervention programme on decreasing hospitalisations and medical costs in patients with chronic obstructive pulmonary disease in China: protocol of a randomised controlled trial.
Patients with chronic obstructive pulmonary disease (COPD) often have multiple hospitalisations because of exacerbation. Evidence shows disease management programmes are one of the most cost-effective measures to prevent re-hospitalisation for COPD exacerbation, but lack implementation and economic appraisal in China. The aims of the proposed study are to determine whether a hospital outreach invention programme for disease management can decrease hospitalisations and medical costs in patients with COPD in China. Economic appraisal of the programme will also be carried out.



A randomised single-blinded controlled trial will be conducted. 220 COPD patients with exacerbations will be recruited from the Third Xiangya Hospital, Central South University, China. After hospital discharge they will be randomly allocated into an intervention or a control group. Participants in the intervention group will attend a 3-month hospital-based pulmonary rehabilitation intervention and then receive a home-based programme. Both groups will receive identical usual discharge care before discharge from hospital. The primary outcomes will include rate of hospitalisation and medical cost, while secondary outcomes will include mortality, self-efficacy, self-management, health status, quality of life, exercise tolerance and pulmonary function, which will be evaluated at baseline and at 3, 12 and 24 months after the intervention. Cost-effectiveness analysis will be employed for economic appraisal.



The study has been approved by the institutional review board (IRB) of the Third Xiangya Hospital, Central South University (IRB2014-S159). Findings will be shared widely through conference presentations and peer-reviewed publications. Furthermore, the results of the programme will be submitted to health authorities and policy reform will be recommended.



Chi CTR-TRC-14005108; Pre-results.
The Third Xiangya Hospital, Central South University, Changsha, China Xiangya Nursing School of Central South University, Changsha, China.
Jin
J
Yan
Xiangya Nursing School of Central South University, Changsha, China Nursing School of ZunYi Medical College, Guizhou, China.
Lianhong
L
Wang
The Third Xiangya Hospital, Central South University, Changsha, China.
Chun
C
Liu
The Third Xiangya Hospital, Central South University, Changsha, China.
Hong
H
Yuan
The Center for Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Xiaowan
X
Wang
The Center for Health Policy and Management, Shandong University, Shandong, China.
Baorong
B
Yu
Nursing School of ZunYi Medical College, Guizhou, China.
Qian
Q
Luo
D000328:Adult; D000368:Aged; D002681:China; D003362:Cost-Benefit Analysis / Q000706:statistics & numerical data; D019468:Disease Management; D018450:Disease Progression; D017079:Exercise Tolerance; D005260:Female; D017048:Health Care Costs; D006761:Hospitals; D006801:Humans; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data*; D016730:Program Development / Q000191:economics*; D029424:Pulmonary Disease, Chronic Obstructive / Q000534:rehabilitation*; D011788:Quality of Life; D012107:Research Design; D000073278:Self-Management; D016037:Single-Blind Method