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A retrospective study of the impact of a telephone alert service (Healthy Outlook) on hospital admissions for patients with chronic obstructive pulmonary disease.

Sarran C, Halpin D, Levy ML, Prigmore S, Sachon P - NPJ Prim Care Respir Med (2014)

Bottom Line: Its objective is to reduce the severity and length of COPD exacerbations, hence improving the quality of life and life expectancy.To assess the effect of the Healthy Outlook service on hospital admission rates of all general practitioners that have used the service.The differences in admission rates per practice between the first year of use of the Healthy Outlook service and the previous year were compared by paired t-test analyses.

View Article: PubMed Central - PubMed

Affiliation: Met Office, Exeter, UK.

ABSTRACT

Background: Healthy Outlook is a service delivered by the UK Met Office directly to patients with chronic obstructive pulmonary disease (COPD) that has been in place since 2006. Its objective is to reduce the severity and length of COPD exacerbations, hence improving the quality of life and life expectancy.

Aims: To assess the effect of the Healthy Outlook service on hospital admission rates of all general practitioners that have used the service.

Methods: Control practices were selected for each of the 661 participating practices. The number of hospital admissions for each practice was extracted from the Hospital Episode Statistics database. The differences in admission rates per practice between the first year of use of the Healthy Outlook service and the previous year were compared by paired t-test analyses.

Results: For admissions with a primary diagnosis of COPD, the difference between participating and control practices was -0.8% (95% confidence interval (CI)=-1.8 to 0.2%; P=0.13). For admissions with a primary or co-morbid diagnosis of COPD, the difference was -2.3% (95% CI=-4.2 to -0.4%; P=0.02).

Conclusions: Participation in the Healthy Outlook service reduces hospital admission rates for patients coded on discharge with COPD (including co-morbid).

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Related in: MedlinePlus

Index of Multiple Deprivation (IMD) and percentage of registered patients aged over 65 of matched control practices against participating practices. An equivalent plot for rurality class is not shown because its categorical nature makes the plot unhelpful.
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fig2: Index of Multiple Deprivation (IMD) and percentage of registered patients aged over 65 of matched control practices against participating practices. An equivalent plot for rurality class is not shown because its categorical nature makes the plot unhelpful.

Mentions: Histograms of the characteristics for practices participating in Healthy Outlook and for all general practices in England are compared in Figure 1: the plots suggest that the distribution of participating practices does not differ much from that of an average English practice. From matching a control practice to each participating practice, the mean percentile difference between matched practices was 2.3% with 95% of matches with a percentile difference within 0.8–4.3%. Figure 2 shows a comparison of the IMD and age between participating and control practices, the tight clustering of the points along the diagonal suggesting a good match. Paired t-tests of the admission rates for heart failure and myocardial infarction in the year before the start of the service resulted in a mean difference between the two groups of −0.01‰ (95% confidence interval (CI)=−0.08 to 0.07‰; P=0.9) for heart failure and −0.02‰ (95% CI=−0.09 to 0.05‰; P=0.6) for myocardial infarction. This suggests that the participating practices are well matched to their controls as there were no differences in emergency hospital admission rates for these two outcomes.


A retrospective study of the impact of a telephone alert service (Healthy Outlook) on hospital admissions for patients with chronic obstructive pulmonary disease.

Sarran C, Halpin D, Levy ML, Prigmore S, Sachon P - NPJ Prim Care Respir Med (2014)

Index of Multiple Deprivation (IMD) and percentage of registered patients aged over 65 of matched control practices against participating practices. An equivalent plot for rurality class is not shown because its categorical nature makes the plot unhelpful.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4373472&req=5

fig2: Index of Multiple Deprivation (IMD) and percentage of registered patients aged over 65 of matched control practices against participating practices. An equivalent plot for rurality class is not shown because its categorical nature makes the plot unhelpful.
Mentions: Histograms of the characteristics for practices participating in Healthy Outlook and for all general practices in England are compared in Figure 1: the plots suggest that the distribution of participating practices does not differ much from that of an average English practice. From matching a control practice to each participating practice, the mean percentile difference between matched practices was 2.3% with 95% of matches with a percentile difference within 0.8–4.3%. Figure 2 shows a comparison of the IMD and age between participating and control practices, the tight clustering of the points along the diagonal suggesting a good match. Paired t-tests of the admission rates for heart failure and myocardial infarction in the year before the start of the service resulted in a mean difference between the two groups of −0.01‰ (95% confidence interval (CI)=−0.08 to 0.07‰; P=0.9) for heart failure and −0.02‰ (95% CI=−0.09 to 0.05‰; P=0.6) for myocardial infarction. This suggests that the participating practices are well matched to their controls as there were no differences in emergency hospital admission rates for these two outcomes.

Bottom Line: Its objective is to reduce the severity and length of COPD exacerbations, hence improving the quality of life and life expectancy.To assess the effect of the Healthy Outlook service on hospital admission rates of all general practitioners that have used the service.The differences in admission rates per practice between the first year of use of the Healthy Outlook service and the previous year were compared by paired t-test analyses.

View Article: PubMed Central - PubMed

Affiliation: Met Office, Exeter, UK.

ABSTRACT

Background: Healthy Outlook is a service delivered by the UK Met Office directly to patients with chronic obstructive pulmonary disease (COPD) that has been in place since 2006. Its objective is to reduce the severity and length of COPD exacerbations, hence improving the quality of life and life expectancy.

Aims: To assess the effect of the Healthy Outlook service on hospital admission rates of all general practitioners that have used the service.

Methods: Control practices were selected for each of the 661 participating practices. The number of hospital admissions for each practice was extracted from the Hospital Episode Statistics database. The differences in admission rates per practice between the first year of use of the Healthy Outlook service and the previous year were compared by paired t-test analyses.

Results: For admissions with a primary diagnosis of COPD, the difference between participating and control practices was -0.8% (95% confidence interval (CI)=-1.8 to 0.2%; P=0.13). For admissions with a primary or co-morbid diagnosis of COPD, the difference was -2.3% (95% CI=-4.2 to -0.4%; P=0.02).

Conclusions: Participation in the Healthy Outlook service reduces hospital admission rates for patients coded on discharge with COPD (including co-morbid).

Show MeSH
Related in: MedlinePlus