Evidence map›Paper›PMID 36905535›Full record

ArticlePharmacoEconomics - open2023

Cost Analysis of a Transition Care Bundle Compared with Usual Care for COPD Patients Being Discharged from Hospital: Evaluation of a Randomized Controlled Trial.

Charles Yan, Jeff Round, Ilke Akpinar, Chantal E Atwood, Lesly Deuchar, Mohit Bhutani, Richard Leigh, Michael K Stickland

Open access · goldAbstract read
In one paragraph

Article in PharmacoEconomics - open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
2.6field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 10 citations in OpenAlex.

  1. Impact of an Inpatient COPD Care Pathway on Hospital Care Process and Outcome Metrics.Chronic obstructive pulmonary diseases (Miami, Fla.) · 2025
    Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Charles YanInstitute of Health Economics, 10405 Jasper Avenue, Edmonton, AB, T5J 3N4, Canada. cyan@ihe.ca.ORCID http://orcid.org/0000-0002-7275-9345
Jeff RoundInstitute of Health Economics, Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
Ilke AkpinarInstitute of Health Economics, School of Public Health, University of Alberta, Edmonton, AB, Canada.
Chantal E AtwoodMedicine Strategic Clinical Network™, Alberta Health Services, Data and Analytics, Methodology and Executive Reporting, Alberta Health Services, Calgary, AB, Canada.
Lesly DeucharPerformance and Innovation Manager, Edmonton Zone Virtual Hospital, Alberta Health Services, Edmonton, AB, Canada.
Mohit BhutaniMedicine Strategic Clinical Network™, Alberta Health Services, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, USA.
Richard LeighMedicine Strategic Clinical Network™, Alberta Health Services, Cumming School of Medicine, Department of Medicine, University of Calgary, Calgary, AB, Canada.
Michael K SticklandMedicine Strategic Clinical Network™, Alberta Health Services, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, USA.
Alberta Health Services · CAUniversity of Alberta · CAInstitute of Health Economics · CA

Funding

Alberta Innovates - Health Solutions 201400390Canadian Institute of Health Research 138884
6 · The paper itself

Abstract

backgroundAppropriate management of chronic obstructive pulmonary disease (COPD) patients following acute exacerbations can reduce the risk of future exacerbations, improve health status, and lower care costs. While a transition care bundle (TCB) was associated with lower readmissions to hospitals than usual care (UC), it remains unclear whether the TCB was associated with cost savings.

objectiveThe aim of this study was to evaluate how this TCB was associated with future Emergency Department (ED)/outpatient visits, hospital readmissions, and costs in Alberta, Canada.

methodsPatients who were aged 35 years or older, who were admitted to hospital for a COPD exacerbation, and had not been treated with a care bundle received either TCB or UC. Those who received the TCB were then randomized to either TCB alone or TCB enhanced with a care coordinator. Data collected were ED/outpatient visits, hospital admissions and associated resources used for index admissions, and 7-, 30- and 90-day post-index discharge. A decision model with a 90-day time horizon was developed to estimate the cost. A generalized linear regression was conducted to adjust for imbalance in patient characteristics and comorbidities, and a sensitivity analysis was conducted on the proportion of patients' combined ED/outpatient visits and inpatient admissions as well as the use of a care coordinator.

resultsDifferences in length of stay (LOS) and costs between groups were statistically significant, although with some exceptions. Inpatient LOS and costs were 7.1 days (95% confidence interval [CI] 6.9-7.3) and Canadian dollars (CAN$) 13,131 (95% CI CAN$12,969-CAN$13,294) in UC, 6.1 days (95% CI 5.8-6.5) and CAN$7634 (95% CI CAN$7546-CAN$7722) in TCB with a coordinator, and 5.9 days (95% CI 5.6-6.2) and CAN$8080 (95% CI CAN$7975-CAN$8184) in TCB without a coordinator. Decision modelling indicated TCB was less costly than UC, with a mean (standard deviation [SD]) of CAN$10,172 (40) versus CAN$15,588 (85), and TCB with a coordinator was slightly less costly than without a coordinator (CAN$10,109 [49] versus CAN$10,244 [57]).

conclusionThis study suggests that the use of the TCB, with or without a care coordinator, appears to be an economically attractive intervention compared with UC.

Identifiers

PMID36905535
PMCPMC10169973
OpenAlexW4323921312

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.