Hospital at home and early discharge schemes for patients experiencing an acute exacerbation of their chronic obstructive pulmonary disease, appear to be an effective and safe option for selected patients and these services have become increasingly common. Here we discuss the evaluation of such schemes including: the rationale for evaluation; aspects of quality which might be considered for evaluation; the role of evaluation frameworks, quantitative and qualitative evaluation and steps in planning an evaluation.
Price LC, Lowe D, Hosker H, Anstey K, Pearson M, Roberts CM.The UK National COPD Audit 2003: impact of hospital resources and organisation of care on patient outcome following admissions for acute hospital resources and organisation of care on COPD exacerbation. Thorax published online 31 Jan 2006; doi: 10.1136/thx.2005.049940.
2.
Ram FSF, Wedzicha JA, Wright J, Greenstone M.Hospital at home for patients with acute exacerbations of chronic obstructive pulmonary disease: systematic review of evidence. Br Med J2004; 329: 315-319.
3.
Candy B, Taylor SJC, Griffiths CJet al.Evaluating the effectiveness of innovations involving nurses for people with chronic obstructive airways disease. Report for NHS SDO Programme of Research on Evaluating Innovations in the Organisation and Delivery of Health Services. Institute of Community Health Science, Barts and The London, Queen Mary’s School of Medicine and Dentistry, March 2004. Available at:www.sdo.lshtm.ac.uk/nursingandmidwifery.htm%23taylor.
4.
Campbell M, Fitzpatrick R, Haines Aet al.Framework for design and evaluation of complex interventions to improve health. Br Med J2000; 321: 694-696.
5.
Candy B, Taylor SJC, Ramsay JM, Esmond G, Grifiths CJ, Bryar RM.Service implications from a comparison of the evidence on the effectiveness and a survey of provision in England and Wales of COPD specialist nurse services in the community. Int J Nurs Stud, published online February 2006.
6.
St Leger AS, Schnieden H, Wolsworth-Bell JP.Evaluating health services’ effectiveness. Open University Press, 1992.
7.
Maxwell, RJ.Quality assessment in health. Br Med J (Clin Res Ed)1984; 288: 1470-1472.
8.
Smith S, Sinclair D, Raine R, Reeves B.Health care evaluation. Open University Press, 2005.
9.
Donabedian A.Evaluating the quality of medical care. Milbank Memorial Fund Quarterly: Health and Society1966; 44: 166-203.
10.
Steckler A, Linnan L eds. Process evaluation for public health interventions and research. Jossey-Bass, 2002.
11.
Last JM ed. A dictionary of epidemiology. Open University Press Inc., 2000.
12.
Gravil JH, Al-Rawas OA, Cotton MM, Flanigan U, Irwin A, Stevenson RD.Home treatment of acute exacerbations of chronic obstructive pulmonary disease by an acute respiratory assessment service. Lancet1998; 352: 1853-1855.
13.
Davies L, Wilkinson M, Bonner S, Calverley PMA, Angus RM.“Hospital at home” versus hospital care in patients with exacerbations of chronic obstructive pulmonary disease: prospective randomised controlled trial. Br Med J2000; 321: 1265-1268.
14.
Skwarska E, Cohen G, Skwarski KMet al.Randomised controlled trial of supported discharge in patients with exacerbations of chronic obstructive pulmonary disease. Thorax2000; 55: 907-912.
15.
Clarke A.Readmission to hospital: a measure of quality or outcome. Qual Saf Health Care2004; 13: 10-11.
16.
Holguin F, Folch E, Redd SC, Mannino DM.Comorbidity and mortality in COPD-related hospitalizations in the United States, 1979 to 2001. Chest2005; 128: 2005-2011.
17.
Bowling A.Measuring health: a review of quality if life measuring scales, 2nd edition. Open University Press, 1997.
18.
Booth S, Silvester S, Todd C.Breathlessness in cancer and chronic obstructive pulmonary disease: Using a qualitative approach to describe the experience of patients and carers. Palliat Support Care2003; 1: 337-344.
19.
Ware JE, Sherbourne CD.He MOS 36-item short-form health survey (SF-36). I Conceptual framework and item selection. Med Care1992; 30: 473-483.
20.
Jones PW, Quirk FH, Baveystock CM.The St George’s Respiratory Questionnaire. Respir Med1991; 85: 25-31.
21.
Jones PW, Spencer S, Adies S.The St George’s Respiratory Questionnaire manual version 2.1. Respir Med2003.
22.
Jones PW.Interpreting thresholds for a clinically significant change in health status in asthma and COPD. Eur Respir J2002; 19: 398-404.
23.
Ståhl E, Jansson S-A, Jonsson A-C, Svensson, Lundbäck B, Andersson F.Health-related quality of life, utility and productivity outcomes: ease of completion by subjects with COPD. Health and Quality of Life Outcomes2003; 1: 18-18 (wwww.hqlo.com.content/1/1/18, accessed 1/2/2006).
24.
Ojoo JC, Moon T, McGlone Set al.Patients’ and carers’ preferences in two models of care for acute exacerbations of COPD: results of a trial. Thorax2002; 57: 167-169.
25.
Cohen G, Forbes J, Garraway M.Can different patient satisfaction survey methods yield consistent results?Br Med J1996; 313: 841-844.
26.
Delbanco TL.Quality of care through the patient’s eyes. Br Med J1996; 313: 832-833.
27.
Gavin KT, Turner MJ.Patinets should help decide the wording and design of questionnaires. Br Med J1997; 314: 227-227.
28.
Sala E, Alegre L, Carrerra Met al.Supported discharge shortens hospital stay in patients hospitalized because of an exacerbation of COPD. Eur Respir J2001; 17: 1138-1142.
29.
Altman DG.Practical statistics for medical research. Chapman & Hall, 1991.
30.
Pope C.Qualitative research: Reaching the parts other methods cannot reach: an introduction to qualitative methods in health and health services research. Br Med J1995; 311: 42-45.
31.
Miles MB, Huberman AM.Qualitative data analysis: an expanded sourcebook, 2nd edition. SAGE Publications, 1994.
32.
Mays N, Pope C.Qualitative research: observational methods in health care settings. Br Med J1995; 311: 182-184.
Lorig KR, Holman HR.Self-management education: history, definitions, outcomes and mechanisms. Annals of Behavioural Medicine2003; 26: 1-7.
35.
Moher D, Schulz KF, Altman DG for the CONSORT Group. The CONSORT statement: revised recommendations for improving the quality of reports of parallel-group randomised trials. Lancet2001; 357: 1191-1194.
36.
Gibbons D, Hamilton J, Maw G, Telford J.Developing a nurse-led service for COPD patients. Professional Nurse2001; 16: 1035-1037.
37.
St Leger AS, Wolsworth-Bell JP.Change-promoting research for health services: a guide for resource managers, research and development commissioners and researchers. Open University Press, 1999.
38.
Grbich C.Qualitative research in health an introduction. SAGE Publications, 1999.
