Focus on the treatment of COPD patients.
A new health atlas has been published by the Centre for Clinical Documentation and Evaluation (SKDE). This time, the focus is on the consumption of healthcare services for individuals with COPD.
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It is a primary health policy objective in Norway that there should be equitable health services for all – regardless of where one lives.
The Health Atlas is a tool for comparing the population's use of health services in different geographical areas, irrespective of where the patients are treated. The Health Atlas for COPD was published to map the use of health services for individuals with COPD during the period 2013-2015.
- The Health Atlas for COPD shows whether COPD patients in Norway receive equitable health services, regardless of where they live, says project leader and analyst at SKDE, Linda Leivseth.
Mapping the treatment of COPD patients
In the new health atlas, SKDE has mapped the use of spirometry, the use of recommended types of ventilatory support, emergency admissions, rehabilitation, and the potential impact of influenza related to COPD exacerbations.
- Generally, it can be said that the Health Atlas for COPD shows that COPD patients are seriously ill, and this is important because they are a resource-intensive patient group, says Leivseth.
Not everyone has their lung function measured
The most important examination conducted during the assessment and monitoring of COPD is the measurement of the patient's lung function, known as spirometry. According to national guidelines, lung function should be measured at least once a year.
- The Health Atlas for COPD shows that not everyone with COPD has their lung function measured each year as recommended, says Leivseth.
The proportion of COPD patients who underwent spirometry varied significantly between the catchment areas, with at least one third not having an annual lung function measurement either with their general practitioner or in specialist healthcare.
In the catchment area of the Hospital in Vestfold, over twice the proportion of COPD patients had their lung function measured by their general practitioner within a year, compared to the catchment area of Finnmark Hospital.
Ventilatory support during emergency admissions
COPD exacerbation refers to episodes of increased respiratory distress that occur in individuals with COPD. In cases of severe COPD exacerbation with respiratory failure, ventilatory support is an effective treatment. The patient receives breathing assistance via a mask with positive pressure.
Findings in the Health Atlas for COPD show unjustified variation in the proportion of emergency admissions for COPD where the recommended type of ventilatory support was provided.
In general, there was a strong correlation between the expected prevalence of COPD and the number of individuals who were admitted as emergencies, although some catchment areas stood out.
Variation in the use of pulmonary rehabilitation
Pulmonary rehabilitation is one of the few interventions for COPD that does not have unwanted side effects and which improves quality of life and reduces the need for hospital admissions.
As an intervention, pulmonary rehabilitation typically includes various offerings such as exercise, patient education, assistance with smoking cessation, nutritional advice, and psychosocial support.
Findings in the Health Atlas for COPD suggest unjustified variation in the availability and use of pulmonary rehabilitation for COPD.
Influenza vaccination may prevent COPD exacerbations
During the winter of 2013 to 2014, there were significantly fewer emergency admissions for COPD than in the years before and after. That same winter, there was low influenza activity in Norway.
Influenza vaccination for individuals with COPD may be a useful measure to prevent COPD exacerbations that lead to hospital admissions.
- There were coincidentally few emergency admissions for COPD in the year when there was low influenza activity, although our analyses cannot provide more concrete information about cause and effect, says Leivseth.