Shifting Hospital Care to the Home Improved Quality of Life for Patients With COPD

Patients with chronic obstructive pulmonary disease (COPD) who received care in their homes had an improved quality of life, according to the results of a Canadian program.

The INSPIRED program shifted chronic care for COPD from the hospital to the home, which reduced hospital readmissions by 64% and emergency department (ED) visits by 52%. The program was first implemented 2014-2015 and there are now results for more than 2000 patients with COPD who have participated in the program.

Through INSPIRED, healthcare teams identify patients who visit the ED or are hospitalized with advanced COPD and provide them with written action plans for managing their disease, follow-up calls after hospital discharge, and at-home self-management education and psychosocial support.

“Too often, people with chronic diseases like COPD end up in hospital because the care they need is not available in the community,” Maureen O’Neil, president of the Canadian Foundation for Healthcare Improvement (CFHI), said in a statement. “INSPIRED provides the services patients and their families tell us they need to manage their disease outside of hospital and now we are expanding this innovative collaboration to benefit more patients.”

The CFHI is providing 1.4 million Canadian dollars (approximately 1.1 million US dollars) in funding to scale up the INSPIRED programs to additional providers, sites, and patients. For the next phase of the program, collaborative teams will reach an additional 2300 people living with advanced COPD by March 2019.

According to CFHI, a third-party analysis found that nearly 70,000 ED visits and 400,000 hospital bed days could be prevented if the program reached 5800 patients annually by 2021. The expansion of the program would result in avoiding 688 million Canadian dollars (more than 557 million US dollars) in acute care costs. Every 1 Canadian dollar invested in INSPIRED could prevent 21 Canadian dollars in hospital-based costs.

“These results are important because they show we can keep people with chronic disease out of the hospital by partnering with them to reinvent the way we deliver care, so it meets their needs,” said Maria Judd, vice president of programs at CFHI.