Open AccessImproving quality of care among COPD outpatients in D enmark 2008–2011
Author(s) -
Tøttenborg Sandra Søgaard,
Thomsen Reimar Wernich,
Nielsen Henrik,
Johnsen Søren Paaske,
Frausing Hansen Ejvind,
Lange Peter
Publication year - 2013
Publication title -
the clinical respiratory journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.789
H-Index - 33
eISSN - 1752-699X
pISSN - 1752-6981
DOI - 10.1111/crj.12009
Subject(s) - medicine , copd , confidence interval , population , prospective cohort study , pulmonary rehabilitation , audit , physical therapy , relative risk , emergency medicine , environmental health , management , economics
Objective To examine whether the quality of care among D anish patients with chronic obstructive pulmonary disease ( COPD ) has improved since the initiation of a national multidisciplinary quality improvement program. Methods We conducted a nationwide, population‐based prospective cohort study using data from the D anish C linical R egister of COPD . Since 2008, the register has systematically monitored and audited the use of recommended processes of COPD care. Results Substantial improvements were observed for all processes of care and registration fulfillment increased to well above 85% for all indicators. Compared with 2008, a higher proportion of COPD outpatients in 2011 received annual measurements of the forced expiratory volume in 1 s in percent of predicted [relative risk ( RR ) 2.14, 95% confidence interval ( CI ), 2.09; 2.19], assessment of body mass index ( RR 2.24, 95% CI , 2.19; 2.29), assessment of dyspnea using the M edical R esearch C ouncil scale ( RR 2.25, 95% CI , 2.20; 2.31), registration of smoking status ( RR 2.41, 95% CI , 2.35; 2.47), smoking cessation recommendation ( RR 3.40, 95% CI , 3.18; 3.64) and offering of pulmonary rehabilitation ( RR 2.78, 95% CI , 2.65; 2.90). Moderate variation in quality of care fulfillment between regions and hospital clinics still existed in 2011. The proportion of patients with mild to moderate COPD increased during the study period ( P < 0.0001). Conclusion Based on increased registration practice of important processes of care, the present study indicates a substantial improvement in the quality of care of COPD in D anish hospitals following the initiation of a national multidisciplinary quality improvement program in 2008. In the forthcoming years, it will be interesting to observe if this will translate into a better prognosis for D anish patients with COPD .