Care delivery pathways for Chronic Obstructive Pulmonary Disease in England and the Netherlands: a comparative study

• Published in: International journal of integrated care Vol. 12; no. 2; p. e40
• Main Authors: Utens, Cecile M A, Maarse, J A M, van Schayck, Onno C P, Maesen, Boudewijn L P, Rutten, Maureen P M H, Smeenk, Frank W J M
• Format: Journal Article
• Language: English
• Published: England Ubiquity Press 01-04-2012; Igitur, Utrecht Publishing & Archiving
• Subjects: care delivery pathway; Chronic illnesses; Chronic obstructive pulmonary disease; Comorbidity; comparative analysis; COPD exacerbation; Costs; Disease management; Family physicians; Health care expenditures; hospital at home; Hospitalization; Hospitals; Length of stay; Nurses; Patient admissions; Policy Paper; Practice nursing; Primary care; United Kingdom > UK; England; Netherlands; comparative analysis; care delivery pathways; hospital-at-home, integrated care; exacerbations; COPD
• ISSN: 1568-4156; 1568-4156
• DOI: 10.5334/ijic.811

A remarkable difference in care delivery pathways for Chronic Obstructive Pulmonary Disease (COPD) is the presence of hospital-at-home for COPD exacerbations in England and its absence in the Netherlands. The objective of this paper is to explain this difference.
Descriptive COPD statistics and care delivery pathways on all care levels within the institutional context, followed by a comparison of care delivery pathways and an explanation of the difference with regard to hospital-at-home.
The Netherlands and England show broad similarities in their care delivery pathways for COPD patients. A major difference is the presence of hospital-at-home for COPD exacerbations in England and its absence in the Netherlands. Three possible explanations for this difference are presented: differences in the urgency for alternatives (higher urgency for alternative treatment models in England), the differences in funding (funding in England facilitated the development of hospital-at-home) and the differences in the substitution of tasks to nurses (substitution to nurses has taken place to a larger extent in England).
The difference between the Netherlands and England regarding hospital-at-home for COPD exacerbations can be explained in three ways. Hospital-at-home has proved to be a safe alternative for hospital care for selected patients, and should be considered as a treatment option for COPD exacerbations in the Netherlands.