Background: Hospitalizations in patients with COPD are severe trajectory changing health events and are a major contributor to health system costs. Integrated disease management (IDM) is cost-effective care demonstrated to prevent acute health service utilisation (HSU) in diverse populations.

Objective: To evaluate whether a primary care IDM program reduces acute HSU events in a real-world setting.

Methods: Individuals with COPD (N=2451), managed with Best Care IDM (2011-2019) were included. HSU data were extracted monthly, 3-years prior to and 3-years following the initial IDM visit, from provincial health administrative databases (Ontario, Canada). We used interrupted time series analyses to compare HSU events pre-intervention to post-IDM trends.

Results: HSU rates increased over 3 years prior to the initial IDM visit. Compared to the predicted trend line at 12 months post-IDM, COPD-related hospitalizations reduced by -9.1(95%CI;-12.72,-5.44) events/1000 individuals/month and COPD-related emergency department (ED) visits reduced by -19.0(95%CI;-25.50,-12.46), at 36 months this difference was almost doubled (Figure 1). At 12 months relative reductions were 56% for hospitalizations and 46% for ED visits. Reductions were also observed for all-cause HSU.

Conclusion: Primary-care based COPD IDM was associated with an improved disease trajectory, reduced COPD-related ED visits and hospitalization.