ABS77: Organisation of asthma and COPD care in secondary care in Mid-Sweden

Abstract

To investigate the organisation in secondary care with regard to management of COPD. The Swedish National Board of Health and Welfare assessed guidelines for diagnosis and management of asthma and COPD in 2004. This study intends to compare these guidelines to the actually performed care in Mid-Sweden. The aim of this report is to compare the resources in organisation and equipment for COPD in secondary care in this region. A survey was sent in 2005 to all seven regional/county hospitals and to seven local hospitals in the region. The survey included 40 questions about resources for management of asthma and COPD in secondary care. With reference to the guidelines of the Swedish National Board of Health and Welfare five quality indicators were constructed for the care of COPD in secondary care. These were access to the local and regional guidelines for COPD, spirometer, programme for smoking cessation, physiotherapy for COPD patients, multidisciplinary rehabilitation. Three of the 14 hospitals (two regional/county hospitals and one local hospital) fulfilled all quality criteria. The greatest shortcoming was smoking cessation where 7 out of 14 lacked a structured programme. 6 out of 14 also lacked resources for multidisciplinary rehabilitation and local guidelines. The criterion that most hospitals fulfilled, 13 out of 14, was access to spirometer. There are differences in resources in secondary care for patients with COPD in this Swedish region. The greatest shortcoming is access to smoking cessation programmes, which is a serious problem since this is the only treatment that has shown to be of significant importance for the prognosis of COPD. The development of local guidelines and resources for multidisciplinary rehabilitation for COPD is also important to improve the care of this large disease-group. Conflict of interest and funding None.