Forskning
Udskriv Udskriv
Switch language
Hvidovre Hospital - en del af Københavns Universitetshospital
Udgivet

Reducing socioeconomic inequalities in COPD care in the hospital outpatient setting - A nationwide initiative

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

  1. Sex differences between women and men with COPD: A new analysis of the 3CIA study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Prognosis of COPD depends on severity of exacerbation history: A population-based analysis

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Interstitial lung abnormalities are associated with increased mortality in smokers

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Efficacy of a minimal home-based psychoeducative intervention in patients with advanced COPD: A randomised controlled trial

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Cardiorespiratory responses to high intensity skeletal muscle metaboreflex activation in chronic obstructive pulmonary disease

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Sex differences between women and men with COPD: A new analysis of the 3CIA study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Comorbidity Clusters and Healthcare Use in Individuals With COPD

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  • Sandra S Tøttenborg
  • Peter Lange
  • Reimar W Thomsen
  • Henrik Nielsen
  • Søren Paaske Johnsen
Vis graf over relationer

OBJECTIVE: Socioeconomic differences in quality of care have been suggested to contribute to inequality in clinical prognosis of COPD. We examined socioeconomic differences in the quality of COPD outpatient care and the potential of a systematic quality improvement initiative in reducing potential socioeconomic differences.

METHODS: A mandatory national quality improvement initiative has since 2008 monitored the quality of COPD care at all national pulmonary specialized outpatient clinics in Denmark using six evidence-based process performance measures. We followed patients aged ≥30 years with a first-ever outpatient contact for COPD during 2008-2012 (N = 23,741). Adjusted year-specific relative risks (RR) of fulfilling all relevant process performance measures was compared according to ethnicity, education, income, employment, and cohabitation using Poisson regression.

RESULTS: Quality of care improved following the implementation of the clinical improvement initiative with 11% of COPD patients receiving optimal care in 2008 compared to 57% in 2012. Substantial socioeconomic differences were observed the first year: immigrants (RR 0.41, 95% CI 0.21-0.82), the unemployed (RR 0.37, 95% CI 0.18-0.74), disability pensioners (RR 0.63, 95% CI 0.46-0.87) and patients living alone (RR 0.80, 95% CI 0.60-0.97) were less likely to receive all relevant care processes, whereas those with highest education (RR 1.22, 95% CI 0.92-1.63) were more likely to receive these processes. These differences were eliminated during the study period.

CONCLUSION: A systematic quality improvement initiative including regular audits, knowledge sharing, and detailed disease-specific recommendations for care improvement may increase the overall quality of care and considerably modify the substantial socioeconomic inequalities in COPD management.

OriginalsprogEngelsk
TidsskriftRespiratory medicine
Vol/bind125
Sider (fra-til)19-23
ISSN0954-6111
DOI
StatusUdgivet - apr. 2017

ID: 50163030