How might New Zealand reduce hospitalisations for chronic obstructive pulmonary disease?
Chronic obstructive pulmonary disease (COPD) is estimated to affect 300 million people worldwide and is the fourth leading cause of chronic morbidity and mortality, both nationally and internationally. COPD includes conditions such as chronic bronchitis and emphysema. Because it is often associated with other chronic conditions, people with COPD may require complex care and have frequent hospitalisations. The hospital admission rates are high in New Zealand compared with other OECD countries.
Senior Lecturer Anna Askerud investigated an integrated care model called "hospital at home" as a potential option for improved care for New Zealanders with moderate to severe COPD. She looked at the international experience of "hospital at home" for COPD care, and the Canterbury District Health Board programme, the only one in New Zealand.
She found that successful "hospital at home" models of care involved multi-disciplinary teams caring for people with COPD in their own homes using a case management model of care. Providing medications for exacerbations and developing acute and long-term care plans can give people with COPD knowledge and control over their health, enabling them to improve management of their condition and reducing hospitalisations.
Anna recommends this option be developed for implementation as a model of care more widely in New Zealand for moderate to end stage COPD. Improved care at home would reduce the stress of hospitalisations for patients and their families. She is pleased that a Health Care Home model of care is now being introduced to selected GP practices in the Southern District after the Midlands and Capital Coast successfully instigated this model of care in 2017.
Image credit: First Minister of Scotland, used under Creative Commons licence CC-BY-NC-2.0