Impact of a multidisciplinary interstitial lung disease clinic on healthcare utilization

Abstract

RATIONALEA minimal amount is known of the impact that a multidisciplinary interstitial lung disease (ILD) clinic with dedicated nursing support may have on healthcare utilization. OBJECTIVES The objective of this study is to determine if there is a reduction in healthcare utilization including emergency room (ER) visits, hospitalizations, and hospitalization costs in the year after a patient is assessed in the ILD clinic. METHODS This retrospective study evaluated the number of ER visits and hospitalizations 1 year before and after being seen in an ILD clinic. For those with hospitalizations, length of stay (LOS) and cost of each stay were collected. Pre- and post-ILD clinic outcomes were compared using Mann-Whitney and Wilcoxon rank sum test. MEASUREMENTS AND MAIN RESULTSA total of 202 patients were screened and 140 included in the analysis. Mean age was 66 years (±12), and 47% were female. Mean forced vital capacity percentage predicted was 77% (±22). There was no significant difference in the pre- and post-ILD clinic mean number of ER visits per patient (p = 0.33) nor hospitalizations (p = 0.91). LOS was shorter in the post-ILD clinic period (10.8 ± 10.5 days) versus pre-ILD clinic visit (18.8 ± 25.4 days), although not statistically significant (p = 0.30). Pre-ILD clinic visit mean hospitalization cost was $24,881.89 (±35,817.48) and post-ILD clinic visit was $16,751.68 (±16,549.74) although not statistically different (p = 0.66). CONCLUSIONS We found no statistically significant difference in ER visits, hospitalizations or hospitalization costs post-ILD multidisciplinary clinic assessment in our ILD cohort. However, there was a trend toward lower overall healthcare utilization and cost in the year post-ILD clinic.