Author/Authors :
Guertin, Jason R. Programs for Assessment of Technology in Health -The Research Institute of St. Joe’s Hamilton - St. Joseph’s Healthcare Hamilton, Hamilton, Canada , Bowen, James M. Programs for Assessment of Technology in Health -The Research Institute of St. Joe’s Hamilton - St. Joseph’s Healthcare Hamilton, Hamilton, Canada , Gosse, Carolyn St. Joseph’s Healthcare Hamilton, Hamilton, Canada , Blackhouse, Gord Programs for Assessment of Technology in Health -The Research Institute of St. Joe’s Hamilton - St. Joseph’s Healthcare Hamilton, Hamilton, Canada , O’Reilly, Daria J. Programs for Assessment of Technology in Health -The Research Institute of St. Joe’s Hamilton - St. Joseph’s Healthcare Hamilton, Hamilton, Canada , Baltaga, Emanuel St. Joseph’s Healthcare Hamilton, Hamilton, Canada , Cox, Gerard St. Joseph’s Healthcare Hamilton, Hamilton, Canada , Johnson, Donna St. Joseph’s Healthcare Hamilton, Hamilton, Canada , Blanc, Brandi Le St. Joseph’s Healthcare Hamilton, Hamilton, Canada , Smith, Kevin St. Joseph’s Healthcare Hamilton, Hamilton, Canada , Tarride, Jean-Eric St. Joseph’s Healthcare Hamilton, Hamilton, Canada
Abstract :
Background. St. Joseph’s Health System has implemented an integrated comprehensive care bundle care (ICC) program with the
hopes that it would improve patients’ care while reducing overall costs. The aim of this analysis was to evaluate the performance
of the ICC program within patients admitted with chronic pulmonary obstructive disease (COPD). Methods. We conducted
a retrospective observational cohort study comparing ICC patients to non-ICC patients admitted to St. Joseph’s Healthcare
Hamilton for COPD being discharged with support services between June 2012 and March 2015, using administrative data.
Confounding adjustment was achieved through the use of propensity score matching. Medical resource utilizations during the
initial hospitalization and within the 60 days following discharge were compared using regression models. Results. All 76 patients
who entered the ICC program (100.0%) were matched 1 : 1 to 76 eligible non-ICC patients (28.4%). Length of stay (6.47 [7.29]
versus 9.55 [10.21] days) and resource intensity weights (1.16 [0.80] versus 1.64 [1.69]) were lower in the ICC group within the initial
hospitalization but, while favoring the ICC program, healthcare resource use tended not to differ statistically following discharge.
Interpretation. The ICC program was able to reduce initial medical resource utilization without increasing subsequent medical
resource use
