Introduction: A remarkable difference in care delivery pathways for Chronic Obstructive Pulmonary Disease (COPD) is the presence of hospital- at-home for COPD exacerbations in England and its absence in the Netherlands. The objective of this paper is to explain this difference. Methods: Descriptive COPD statistics and care delivery pathways on all care levels within the institutional context, followed by a comparison of care delivery pathways and an explanation of the difference with regard to hospital-at-home. Results: The Netherlands and England show broad similarities in their care delivery pathways for COPD patients. A major difference is the presence of hospital-at-home for COPD exacerbations in England and its absence in the Netherlands. Three possible explanations for this difference are presented: differences in the urgency for alternatives (higher urgency for alternative treatment models in England), the differences in funding (funding in England facilitated the development of hospital-at-home) and the differences in the substitution of tasks to nurses (substitution to nurses has taken place to a larger extent in England). Discussion and Conclusion: The difference between the Netherlands and England regarding hospital-at-home for COPD exacerbations can be explained in three ways. Hospital-at-home has proved to be a safe alternative for hospital care for selected patients, and should be considered as a treatment option for COPD exacerbations in the Netherlands.

hdl.handle.net/1765/38902
International Journal of Integrated Care
Erasmus School of Health Policy & Management (ESHPM)

Utens, C., Maarse, J. A. M., Schayck, O., Maesen, B., Rutten-van Mölken, M., & Smeenk, F. (2012). Care delivery pathways for Chronic Obstructive Pulmonary Disease in England and the Netherlands: a comparative study. International Journal of Integrated Care, 12(May 2012), 1–9. Retrieved from http://hdl.handle.net/1765/38902