Table of Contents Author Guidelines Submit a Manuscript
Canadian Respiratory Journal
Volume 2017 (2017), Article ID 7049483, 10 pages
Research Article

Preliminary Results of the Adoption and Application of the Integrated Comprehensive Care Bundle Care Program When Treating Patients with Chronic Obstructive Pulmonary Disease

1Programs for Assessment of Technology in Health, The Research Institute of St. Joe’s Hamilton, St. Joseph’s Healthcare Hamilton, Hamilton, ON, Canada
2Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
3Department of Social and Preventive Medicine, Université Laval, Quebec City, QC, Canada
4Centre de Recherche du CHU de Québec, Université Laval, Axe Santé des Populations et Pratiques Optimales en Santé, Hôpital du St-Sacrement, Quebec City, QC, Canada
5St. Joseph’s Healthcare Hamilton, Hamilton, ON, Canada
6Department of Medicine, DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
7Center for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada

Correspondence should be addressed to Jean-Eric Tarride

Received 12 January 2017; Revised 12 May 2017; Accepted 18 June 2017; Published 7 August 2017

Academic Editor: Alice M. Turner

Copyright © 2017 Jason R. Guertin et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. St. Joseph’s Health System has implemented an integrated comprehensive care bundle care (ICC) program with the hopes that it would improve patients’ care while reducing overall costs. The aim of this analysis was to evaluate the performance of the ICC program within patients admitted with chronic pulmonary obstructive disease (COPD). Methods. We conducted a retrospective observational cohort study comparing ICC patients to non-ICC patients admitted to St. Joseph’s Healthcare Hamilton for COPD being discharged with support services between June 2012 and March 2015, using administrative data. Confounding adjustment was achieved through the use of propensity score matching. Medical resource utilizations during the initial hospitalization and within the 60 days following discharge were compared using regression models. Results. All 76 patients who entered the ICC program (100.0%) were matched 1 : 1 to 76 eligible non-ICC patients (28.4%). Length of stay (6.47 [7.29] versus 9.55 [10.21] days) and resource intensity weights (1.16 [0.80] versus 1.64 [1.69]) were lower in the ICC group within the initial hospitalization but, while favoring the ICC program, healthcare resource use tended not to differ statistically following discharge. Interpretation. The ICC program was able to reduce initial medical resource utilization without increasing subsequent medical resource use.