How integrated are services for patients with chronic obstructive pulmonary disease? Perceptions of patients and health care providers
S. E. Kirby A B F , M. Mutimbe D , S. Vagholkar C E , J. Bunker C E , S. M. Dennis A C and S.-T. Liaw A C EA Centre for Primary Health Care and Equity, University of New South Wales, UNSW Sydney, NSW 2052, Australia.
B Department of Rural Health, Broken Hill, University of Sydney, Corrindah Court, PO Box 457, Broken Hill, NSW 2880, Australia.
C General Practice Unit, Fairfield Hospital, PO Box 6732, Wetherill Park DC, NSW 1851, Australia.
D Prairiewood Community Health, South Western Sydney Local Health District, Locked Bag 7279, Liverpool BC 187, Australia.
E School of Public Health and Community Medicine, University of New South Wales, UNSW Medicine, NSW 2052, Australia.
F Corresponding author. Email: S.kirby@unsw.edu.au; skirby@gwahs.health.nsw.gov.au
Australian Journal of Primary Health 20(2) 158-161 https://doi.org/10.1071/PY12147
Submitted: 14 November 2012 Accepted: 1 February 2013 Published: 8 March 2013
Abstract
Chronic obstructive pulmonary disease (COPD) is a common cause of hospital readmissions worldwide. Outcomes for COPD patients improve if care is more integrated. COPD patients and their health care providers at a district hospital and community health service were interviewed about their perceptions of integration of care. Patients were confused about provider roles, had little understanding of their disease, had difficulty accessing services and did not have COPD action plans. Health care providers espoused integration of COPD care. Care was reasonably well integrated in the hospital. Integration of care was compromised in the community because COPD patients went to the emergency department when symptoms became unmanageable, while only attending their GPs for routine booked appointments. Integration could be improved if health care providers spent more time with patients, promoting understanding of the disease, supporting self-management and liaising with other providers. Patients would benefit from an action plan and additional support. Potentially preventable COPD admissions will continue without action to improve integration of community services and patients’ understanding of their condition.
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