Nowadays, the number of patients with COPD is constantly growing. COPD is one of the primary reasons for the disability and death of patients. The costs associated with the treatment of exacerbations of the disease in the US rise year by year. All these factors make it essential to address the gap in patients’ quality of care with COPD. Proper routing and coordination of patients’ care will reduce the number of exacerbations and significantly prolong patients’ life while diminishing costs associated with the disease.
The specific gap in healthcare delivery to patients with COPD deals primarily with poor quality of treatment due to the lack of coordination between medical specialists and home health services as well as between physicians and care managers (Rinne et al., 2019). The second block of problems stems from the lack of EHR interoperability, due to which community providers cannot access medical information rapidly, resulting in delayed care (Rinne et al., 2019). Finally, the fields of responsibilities of each actor are not clearly defined, which leads to duplicative efforts and a waste of costly resources.
While nowadays, numerous efforts are made to address the gap in the quality of treatment of patients with COPD, the problem of poor communication between diverse services is rooted in history. Indeed, when there was no internet communication, all papers related to patients’ health had to be delivered manually. Though the situation has improved nowadays, some home health services still use fax machines to obtain the necessary information or documentation. Another related problem is that software at different medical clinics is not always compatible. Thus, for example, radiographs conducted outside a specific clinic may not be properly read, which results in a waste of resources to redo the examination (Rinne et al., 2019). The lack of EHR interoperability is also historically conditioned as, before the introduction of digital technologies into healthcare, it was practically impossible to keep all health-related paper documents from different clinics in one place. Nowadays, the problem is mainly related to the concerns about personal data which cannot be disseminated.
COPD treatment is relatively expensive, and only some of the expenses are covered by insurance. Patients from low-income families have difficulties paying the additional expenses associated with the disease. Thus, socioeconomic background plays a considerable role in access to COPD treatment as not all patients can afford all the procedures recommended by their physician that are not covered by the insurance.
The gap in access to treatment for low-income groups directly affects their health prospects and life expectancy rate. The studies show that inadequate or untimely treatment leads to complications such as pneumonia, bronchiectasis, pneumothorax, pulmonary embolism (PE), and respiratory failure (Ritchie & Wedzicha, 2020). Improper treatment is associated with “trends toward increases in exacerbations, HCRU, and costs […] observed as airflow limitation worsens” (Wallace et al., 2019, p. 205). If the gap in access is not addressed, it will result in low quality of life of patients with COPD, higher expenses on maintenance therapy, and higher mortality rates. The gap in quality of care that stems from the lack of coordination and EHR interoperability leads, in its turn, to higher exacerbation rates. Moreover, it conditions a waste of resources when patients have to undergo the necessary procedures twice due to the absence of conformity within the medical system.
References
Wallace, A. E., Kaila, S., Bayer, V., Shaikh, A., Shinde, M. U., Willey, V. J., Napier, M. B. & Singer, J. R. (2019). Health care resource utilization and exacerbation rates in patients with COPD stratified by disease severity in a commercially insured population. Journal of managed care & specialty pharmacy, 25(2), 205-217. Web.
Rinne, S. T., Resnick, K., Wiener, R. S., Simon, S. R., & Elwy, A. R. (2019). VA provider perspectives on coordinating COPD care across health systems. Journal of General Internal Medicine, 34(1), 37-42. Web.
Ritchie, A. I., & Wedzicha, J. A. (2020). Definition, causes, pathogenesis, and consequences of chronic obstructive pulmonary disease exacerbations. Clinics in chest medicine, 41(3), 421-438. Web.