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Journal of Public Health Advance Access published online on July 9, 2009
Journal of Public Health, doi:10.1093/pubmed/fdp068
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© The Author 2009, Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved

Evaluation of the impact of a health forecast alert service on admissions for chronic obstructive pulmonary disease in Bradford and Airedale


Ravi Maheswaran, Clinical Senior Lecturer in Public Health Medicine1
Tim Pearson, Research Associate in Public Health1
Nagpal Hoysal, Consultant in Public Health Medicine2
Michael J. Campbell, Professor of Medical Statistics3

1 Public Health GIS Unit, School of Health and Related Research, University of Sheffield, Sheffield, UK
2 Department of Public Health, Bradford and Airedale Primary Care Trust, Bradford, UK
3 Health Services Research Section, School of Health and Related Research, University of Sheffield, Sheffield, UK


Address correspondence to R. Maheswaran, E-mail: r.maheswaran{at}sheffield.ac.uk


  Abstract

Background Chronic obstructive pulmonary disease (COPD) exacerbations are associated with adverse weather conditions. We examined if a forecasting alert service available to general practices in Bradford and Airedale for the winter of 2007–08 reduced COPD admissions.

Methods We compared admissions in 2007–08 with 2006–07 when the service was not available. We examined admissions in December to March, and in the 7- and 14-day post-alert periods. There were five alerts in 2006–07 and four in 2007–08. We compared practices using the service to varying extents with practices not using it.

Results Admission rate ratios for practices using the service were 0.98 [95% confidence interval (CI): 0.78–1.22] for December to March, and 0.82 (CI: 0.57–1.18) and 0.95 (CI: 0.72–1.26) for the 7- and 14-day post-alert periods, respectively. When we took into account the proportion of patients entered on the alerts system and the duration for which practices participated in the service, admission rate ratios for practices fully using the service were 1.11 (CI: 0.80–1.52), 1.22 (CI: 0.73–2.04) and 1.21 (CI: 0.82–1.78) for the three corresponding periods.

Conclusion We failed to show that any change in admissions associated with the forecasting service was significant. More research on the effectiveness of the COPD forecasting service is needed.

Keywords: health services


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