Economic and clinical outcomes of easy asthma and chronic obstructive pulmonary disease at Wangtong Hospital, Phitsanulok

Abstract

Wangtong Hospital has implemented an Easy Asthma/COPD Clinic since October 2010 to provide standard treatment system for the patients. The objective of this study was to determine economic and clinical outcomes before and after implementation of Easy Asthma/COPD Clinic at the hospital. The study with a comparative design was carried out using patient database from January 1, 2010 to December 31, 2011. Patients with the diagnosis of asthma and COPD and had treatment continuously for 9 months both before and after implementation of the clinic were included. Data of economic and clinical outcomes were obtained from the hospitals’ electronic database and National Health Security Office website, respectively. Data were analyzed using descriptive statistics, Wilcoxon signed-rank, paired-samples t-tests, and Chi-square. A total of 145 asthma and 217 COPD patients were assessed. All clinical outcomes were improved significantly (P<0.05). After intervention, results showed that average outpatient visit and expenditure increased 18.90-25.76% and 32.31-85.38%, respectively for asthma and COPD. By contrast, use and expenditure associated with emergency and inpatient service decreased 3.26-29.54% and 23.60-71.79%, respectively. Use of inhaled corticosteroid (ICS) increased 5.76-55.33%. For economic outcomes, the program was cost beneficial from societal perspective (incremental benefit to cost ratio of 1.63:1). The outcomes of this study indicate that the interventions of Easy Asthma/COPD Clinic can improve all outcomes and should be implemented at all community hospitals nationwide.