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International Journal for Quality in Health Care Advance Access published online on October 10, 2006
International Journal for Quality in Health Care, doi:10.1093/intqhc/mzl052
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© The Author 2006. Published by Oxford University Press on behalf of International Society for Quality in Health Care; all rights reserved
Accepted September 8, 2006

Article

Evaluation of a regional disease management programme for patients with asthma or chronic obstructive pulmonary disease

Lotte Steuten 1 *, Bert Vrijhoef 2, Frits Van Merode 3, Geert-Jan Wesseling 4, and Cor Spreeuwenberg 2

1 Department of Health Care Studies, Maastricht University, Maastricht, the Netherlands
2 Department of Health Care Studies, Maastricht University, Maastricht, the Netherlands; Department of Integrated Care, University Hospital Maastricht, Maastricht, the Netherlands
3 Department of Health Organisation, Policy and Economics, Maastricht University, Maastricht, the Netherlands
4 Department of Integrated Care, University Hospital Maastricht, Maastricht, the Netherlands; Department of Pulmonology, University Hospital Maastricht, Maastricht, the Netherlands

* To whom correspondence should be addressed.
Lotte Steuten, E-mail: l.steuten{at}zw.unimaas.nl


  Abstract

Objectives. To assess the impact of a population-based disease management programme for adult patients with asthma or chronic obstructive pulmonary disease (COPD) on process measures, intermediate outcomes, and endpoints of care.

Design. Quasi-experimental design with 12-month follow-up.

Setting. Region of Maastricht (the Netherlands) including university hospital and 16 general practices.

Participants. Nine hundred and seventy-five patients of whom 658 have asthma and 317 COPD.

Intervention. Disease management programme.

Main outcome measure(s). Endpoints of care are respiratory health, health utility, patient satisfaction, and total health care costs related to asthma or COPD.

Results. Quality aspects of care, disease control, self-care behaviour, smoking status, disease-specific knowledge, and patients’ satisfaction improved after implementation of the programme. Lung function was not affected by implementation of the programme. For COPD patients, a significant improvement in health utility was found. For patients with asthma, significant cost savings were measured.

Conclusions. Organizing health care according to principles of disease management for adults with asthma or COPD is associated with significant improvements in several processes and outcomes of care, while costs of care do not exceed the existing budget.

Keywords: asthma, COPD, disease management, outcome and process assessment, programme evaluation, quality of health care.
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