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COPD health care in Sweden - A study in primary and secondary care.

Löfdahl, Claes-Göran LU ; Tilling, Björn; Ekström, Tommy; Jörgensen, Leif; Johansson, Gunnar and Larsson, Kjell (2010) In Respiratory Medicine 104. p.404-411
Abstract
OBJECTIVES: To map out-patients with Chronic Obstructive Pulmonary Disease (COPD) with special reference to patients suffering from acute exacerbations, and to describe COPD health care structure and process in Swedish clinical practice in a real life setting. DESIGN: Retrospective, non-interventional, epidemiological survey. SETTING: 141 hospital based out patient clinics (OPC, n=30) and primary health care clinics (PC, n=111) were included in the structure evaluation. SUBJECTS: 1004 COPD diagnosed patients from 100 of the centres (OPC, n=26) participated in the process evaluation. METHODS: All Swedish OPC (n=40) and a random sample of 180 PC were asked to answer a questionnaire regarding COPD care. In addition, data from 10 randomly... (More)
OBJECTIVES: To map out-patients with Chronic Obstructive Pulmonary Disease (COPD) with special reference to patients suffering from acute exacerbations, and to describe COPD health care structure and process in Swedish clinical practice in a real life setting. DESIGN: Retrospective, non-interventional, epidemiological survey. SETTING: 141 hospital based out patient clinics (OPC, n=30) and primary health care clinics (PC, n=111) were included in the structure evaluation. SUBJECTS: 1004 COPD diagnosed patients from 100 of the centres (OPC, n=26) participated in the process evaluation. METHODS: All Swedish OPC (n=40) and a random sample of 180 PC were asked to answer a questionnaire regarding COPD care. In addition, data from 10 randomly selected patients with a documented COPD disease were analysed from the centres. RESULTS: Spirometers were available at all OPCs and at 99% of the PCs. Spirometry had been performed in 52% of PC-patients and in 89% of OPC-patients during the last 2 years prior to the study. More severe patients, as judged by investigator and lung function data, were treated at OPCs than at PCs. Physiotherapists, occupational therapists and dieticians were available at >80% of centres. Exacerbation rate was higher at PCs without a specialized nurse, 2.2/year versus 0.9/year at centres with a specialized nurse. CONCLUSIONS: Special attention to COPD, marked by a specialised nurse in primary care improves the quality, as assessed by a lower number of exacerbations. The structure of COPD care in Sweden for diagnosed individuals seems satisfactory, but could be improved mainly through higher availability and educational activities. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Respiratory Medicine
volume
104
pages
404 - 411
publisher
Elsevier
external identifiers
  • wos:000275572700011
  • pmid:19963361
  • scopus:76649135144
ISSN
1532-3064
DOI
10.1016/j.rmed.2009.10.007
language
English
LU publication?
yes
id
eed1aba0-d355-4108-9a74-c6b59e7c23af (old id 1523929)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/19963361?dopt=Abstract
date added to LUP
2010-01-07 15:41:08
date last changed
2017-01-01 07:51:17
@article{eed1aba0-d355-4108-9a74-c6b59e7c23af,
  abstract     = {OBJECTIVES: To map out-patients with Chronic Obstructive Pulmonary Disease (COPD) with special reference to patients suffering from acute exacerbations, and to describe COPD health care structure and process in Swedish clinical practice in a real life setting. DESIGN: Retrospective, non-interventional, epidemiological survey. SETTING: 141 hospital based out patient clinics (OPC, n=30) and primary health care clinics (PC, n=111) were included in the structure evaluation. SUBJECTS: 1004 COPD diagnosed patients from 100 of the centres (OPC, n=26) participated in the process evaluation. METHODS: All Swedish OPC (n=40) and a random sample of 180 PC were asked to answer a questionnaire regarding COPD care. In addition, data from 10 randomly selected patients with a documented COPD disease were analysed from the centres. RESULTS: Spirometers were available at all OPCs and at 99% of the PCs. Spirometry had been performed in 52% of PC-patients and in 89% of OPC-patients during the last 2 years prior to the study. More severe patients, as judged by investigator and lung function data, were treated at OPCs than at PCs. Physiotherapists, occupational therapists and dieticians were available at >80% of centres. Exacerbation rate was higher at PCs without a specialized nurse, 2.2/year versus 0.9/year at centres with a specialized nurse. CONCLUSIONS: Special attention to COPD, marked by a specialised nurse in primary care improves the quality, as assessed by a lower number of exacerbations. The structure of COPD care in Sweden for diagnosed individuals seems satisfactory, but could be improved mainly through higher availability and educational activities.},
  author       = {Löfdahl, Claes-Göran and Tilling, Björn and Ekström, Tommy and Jörgensen, Leif and Johansson, Gunnar and Larsson, Kjell},
  issn         = {1532-3064},
  language     = {eng},
  pages        = {404--411},
  publisher    = {Elsevier},
  series       = {Respiratory Medicine},
  title        = {COPD health care in Sweden - A study in primary and secondary care.},
  url          = {http://dx.doi.org/10.1016/j.rmed.2009.10.007},
  volume       = {104},
  year         = {2010},
}