scholarly journals Using a Health Economic Framework to Prioritize Quality Indicators: An Example With Smoking Cessation in Chronic Obstructive Pulmonary Disease

2019 ◽  
Vol 4 (1) ◽  
pp. 238146831985235
Author(s):  
Austin Nam ◽  
David M. J. Naimark ◽  
Matthew B. Stanbrook ◽  
Murray D. Krahn
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Health Care ◽  
Health Economic ◽  
Smoking Cessation ◽  
Pulmonary Disease ◽  
Quality Indicators ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Economic Framework ◽  
Life Years

Background. Health care performance monitoring is a major focus of the modern quality movement, resulting in widespread development of quality indicators and making prioritizations an increasing focus. Currently, few prioritization methods of performance measurements give serious consideration to the association of performance with expected health benefits and costs. We demonstrate a proof-of-concept application of using a health economic framework to prioritize quality indicators by expected variations in population health and costs, using smoking cessation in chronic obstructive pulmonary disease (COPD) as an example. Methods. We developed a health state transition, microsimulation model to represent smoking cessation practices for adults with COPD from the health care payer perspective in Ontario, Canada. Variations in life years, quality-adjusted life years (QALYs), and lifetime costs were associated with changes in performance. Incremental net health benefit (INHB) was used to represent the joint variation in mortality, morbidity, and costs associated with the performance of each quality indicator. Results. Using a value threshold of $50,000/QALY, the indicators monitoring assessment of smoking status and smoking cessation interventions were associated with the largest INHBs. Combined performance variations among groups of indicators showed that 81% of the maximum potential INHB could be represented by three out of the six process indicators. Conclusions. A health economic framework can be used to bring dimensions of population health and costs into explicit consideration when prioritizing quality indicators. However, this should not preclude policymakers from considering other dimensions of quality that are not part of this framework.

Cigarette Smoking and Smoking Cessation among Persons with Chronic Obstructive Pulmonary Disease

2006 ◽  
Vol 20 (5) ◽  
pp. 319-323 ◽  
Author(s):  
Jeannine S. Schiller ◽  
Hanyu Ni
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Health Care ◽  
Smoking Cessation ◽  
Pulmonary Disease ◽  
Health Care Providers ◽  
Activity Limitation ◽  
Chronic Obstructive ◽  
Care Providers ◽  
Obstructive Pulmonary Disease ◽  
The Past

Purpose. To identify factors predictive of smoking cessation among adults with chronic obstructive pulmonary disease (COPD). Data from the 1997 to 2002 National Health Interview Surveys were analyzed for adults at least 25 years of age with COPD using logistic regression. Results. Of the adults with COPD, 36.2% were current smokers. Of the current smokers and former smokers who had quit smoking during the past year, 22.9% reported not receiving cessation advice from a health care professional during the past year. Although half of smokers with COPD had attempted to quit during the past year, only 14.6% were successful. Attempting to quit was negatively associated with heavy drinking but positively associated with being younger and having cardiovascular diseases, lung cancer, and activity limitation due to lung problems. Factors predictive of successful cessation included being at least 65 years old, not being poor, and activity limitation due to lung problems. Conclusion. This study underscores the importance of continuing to develop smoking cessation strategies for COPD patients and implementing clinical guidelines on smoking cessation among health care providers.

scholarly journals Validation of smoking cessation self-reported by patients with chronic obstructive pulmonary disease

2011 ◽  
pp. 85 ◽  
Author(s):  
S.R. Hilberink ◽  
Johanna E Jacobs ◽  
Sanne Van Opstal ◽  
Trudy Van der Weijden ◽  
Janine Keegstra ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Smoking Cessation ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease

scholarly journals Perceptions of Home Telemonitoring Use Among Patients With Chronic Obstructive Pulmonary Disease: Qualitative Study

10.2196/16343 ◽  
2020 ◽  
Vol 8 (6) ◽  
pp. e16343 ◽  
Author(s):  
Sara Lundell ◽  
Mari Modig ◽  
Åsa Holmner ◽  
Karin Wadell
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Health Care ◽  
Pulmonary Disease ◽  
Self Management ◽  
Easy Access ◽  
Chronic Obstructive ◽  
Successful Implementation ◽  
Obstructive Pulmonary Disease ◽  
Major Health Problem ◽  
Home Telemonitoring

Background Chronic obstructive pulmonary disease (COPD) is a major health problem and an economic burden globally. There is growing interest in how electronic health (eHealth) can be used to provide efficient health care. Telemonitoring, where the patient’s health-related data is transmitted to a health care provider, can be used to detect early signs of exacerbations. A successful implementation of telemonitoring systems into clinical practice requires in-depth knowledge of the users’ preferences. Objective The aim of this study was to explore perceptions of the use of a home telemonitoring system among patients with COPD. Methods Semistructured individual interviews were carried out with 8 women and 5 men who were participants in a project aimed at developing and evaluating a telemonitoring system. The web-based telemonitoring system measured pulmonary function, subjective symptoms, and oxygen saturation. Participants were interviewed after having used the system for 2-4 months. Interview transcripts were analyzed with qualitative content analysis. Results The analysis resulted in the theme A transition toward increased control and security and four categories: using with (in)security, affecting technical concern or confidence, providing easy access to health care, and increasing control over the disease. The participants reported various perceptions of using the telemonitoring system. They expressed initial feelings of insecurity, both in terms of operating the system and in terms of their disease. However, the practical management of the telemonitoring system became easier with time; the participants gradually gained confidence and improved their self-management. New technology was perceived as an important complement to existing health care, but the importance of maintaining a human contact in real life or through the telemonitoring system was emphasized. Conclusions This study captured a transition among the participants from being insecure and experiencing technical concerns to acquiring technical confidence and improving disease management. Telemonitoring can be a valuable complement to health care, leading to increased self-knowledge, a sense of security, and improved self-management. Suggestions to improve the further development and implementation of telemonitoring systems include better patient education and the involvement of end users in the technical development process. Additional research is needed, particularly in the design of user-friendly systems, as well as in developing tools to predict which patients are most likely to find the equipment useful, as this may result in increased empowerment, improved quality of life, reduced costs, and a contribution to equity in health.

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