Continuity, Regularity, and Specialty in COPD Care: an Exploration of Long-term Costs and Health Outcomes

Project number: 
13-035
Approval date: 
Monday, October 28, 2013
Principal Investigator: 
Sadatsafavi,Mohsen
Institution: 
University of British Columbia (UBC)
Funding Agency: 
Canadian Institutes of Health Research(CIHR),Canadian Respiratory Research Network,Genome Canada
Datasets requested: 
Deaths (BC Vital Statistics Agency)
Medical Services Plan (BC Ministry of Health)
Consolidation - demographic (Ministry of Health)
PharmaNet
Hospital Separations (BC Ministry of Health)
Consolidation registry (Ministry of Health)
Home and Community Care (BC Ministry of Health)
consolidation - census geocodes
Research objective: 

Our specific objectives for the present application include:

Objective 1: To describe and assess the excess resource use in patients with COPD, compared with the general population. We will compare the pattern of ambulatory resource use in COPD patients compared with a matched cohort of patients without COPD. Hypothesis a:Individuals with COPD utilize higher amount of ambulatory care services, both for COPD and non-COPD causes, than the general population.

Objective 2 (Specialty in COPD care): To study the association between care provider's specialty and health and cost outcomes in patients with COPD.

Hypothesis a: Controlled for case mix, initiation of care by specialists after discharge from a COPD-related hospitalization episode is associated with a lower risk of short-term readmission and lower short-term COPD-related medical costs, compared with initiation of care by generalists.
Hypothesis b: Controlled for case mix, care provided by experienced generalists is associated with lower long-term all-cause medical costs, compared with provision of care by specialists.

Objective 3 (Continuity and regularity in COPD care): To study the association between continuity and regularity of care and long-term costs and health outcomes of COPD.
Hypothesis a: Controlled for case mix and intensity of care, continuity and regularity of care are associated with lower long-term rates of all-cause hospital admission and lower long-term direct medical costs.

Publications: 

Journal Publication

  • Chen W, Sin DD, FitzGerald JM, Sadatsafavi M. The Impact of Care Specialty on Survival-adjusted Medical Costs of COPD Patients After a Hospitalization: A longitudinal analysis. Journal of General internal Medicine
    2018 Sep;33(9):1528-1535
  • Excess economic burden of comorbidities in COPD: a 15-year population-based study. Eur Respir J. Chen W, FitzGerald JM, Sin DD, Sadatsafavi M; Canadian Respiratory Research Network.
  • The association between previous and future severe exacerbations of chronic obstructive pulmonary disease: Updating the literature using robust statistical methodology. PLoS One. Sadatsafavi M, Xie H, Etminan M, Johnson K, FitzGerald JM; Canadian Respiratory Research Network. 13(1):e0191243. https://doi.org/10.1371/journal.
    pone.0191243
  • Khakban A, Sin DD, FitzGerald JM, et al. (2017). "The Projected Epidemic of COPD Hospitalizations Over the Next 15 Years: A Population Based Perspective" Am J Respir Crit Care Med, 195(3):287-291.
  • Khakban A, Sin DD, FitzGerald JM, et al. Ten-Year Trends in Direct Costs of COPD: A Population Based Study. Chest. 2015;148(3):640–646.

Presentation of research material (poster/seminar/lecture etc.)

  • Sadatsafavi M. What do real world data say about pharmco-therapy in COPD? Presentation at BC Lung Association Meeting, Vancouver, BC. July 27th, 2018
  • Khakban A, Sin DD, FitzGerald JM, et al. Ten-Year Trends in Direct Costs of COPD: A Population Based Study. Poster presentation (International Agency for Health Economics – Milan, 2015)

Conference abstract/presentation

  • Sadatsafavi, M. Trends of Inhaled Medication Use and Costs in Chronic Obstructive Pulmonary Disease: A 18-Year Population-Based Study. American Thoracic Society International Conference 2018. May 18-23 2018. San Diego, CA USA.
  • Sadatsafavi M, Xie H, FitzGerald JM. Is There A Causal Association Between Past And Future Acute Exacerbations Of COPD? Evidence From A Population-Based Study. Oral presentation (American Thoracic Society – San Francisco, 2016).
  • Sadatsafavi M, Bryan S. Informing policy, practice, and research through an Evaluation Platform in COPD (EPIC). Oral presentation (Canadian Agency for Drugs and Technologies in Health - Saskatoon, 2015).
  • Khakban A, Sin DD, FitzGerald JM, et al. Ten-Year Trends in Direct Costs of COPD: A Population Based Study. Poster presentation (International Agency for Health Economics – Milan, 2015).
  • Sadatsafavi M, Tavakoli H, Kendzerska T, et al. (2015) History of Asthma in Patients with Chronic Obstructive Pulmonary Disease: A Comparative Study of Economic Burden. Ann Am Thorac Soc.

    Sadatsafavi M, Tavakoli H, Kedzerska T, et al. (2016). "History of Asthma in Patients with Chronic Obstructive Pulmonary Disease. A Comparative Study of Economic Burden" Ann Am Thorac Soc, 13:188-196.


Page last revised: September 2, 2019