ABSTRACT
The demographics and consequently the health profile of the population are changing. The greatest challenge that we face over the next 20 years is the management of chronic diseases in an ageing population.1-5 At present, about 80 per cent of ill health, disability and premature deaths are due to chronic diseases. In highly developed countries, the per capita healthcare costs are threefold higher in people aged ≥65 years than the rest of the population.1-6 By the year 2020, the costs for chronic diseases are anticipated to impact on the health budget by 70-80 per cent.1-6 Older adults in poor health are at risk of negative outcomes and are the major consumers of health resources both in hospital and in community settings.3 This socioeconomic trend has resulted in markedly increased interest in delivering effective care to elderly and chronically ill patients in the home.3,5,6
In particular, in chronic obstructive pulmonary disease (COPD) patients, the cost for hospitalization is >40 per cent of the overall cost of COPD care (in the most severe it is >60 per cent).7 Mortality during hospitalization is high and 63 per cent of patients are readmitted in the year following an exacerbation.7
