Integrated care: a new model for COPD management? Society for Clinical Respiratory Physiology

摘要

In order to decrease the cost of hospitalised patients, supported discharge or hospitals at home schemes have been advocated. Where generic management home-based schemes have been used for chronic disease patients, no benefit has been found for COPD [11-14]. A Scottish observational study of 962 patients with COPD also found benefit for hospital-led home-based care [15], but a recent Australian randomised controlled study found no benefit [16]. However, the number of randomised controlled trials using this approach has been relatively small. In a systematic review, Ram et al. [17] found seven such trials involving a total of only 754 patients, but were able to conclude that home-based schemes are associated with cost savings as well as decreased hospitalisation.