Wrong Care in the Wrong Place: Time to Fix Canadas Failing

Approach to Chronic Disease

21/06/2016

CFHI Shows Care Closer to Home Can Cut Hospitalizations and Improve Outcomes
Ottawa, Ontario June 21, 2016 Unnecessary hospitalizations due to chronic disease are
reaching the tipping point of seriously harming this countrys healthcare system and do not meet the
needs of patients and their families, according to a report by the Canadian Foundation for
Healthcare Improvement (CFHI).
Across Canada, patients end up seeking care in emergency departments to manage their chronic
illnesses because more appropriate care isnt available in the community, says Maureen ONeil,
O.C., President of CFHI. These patients are getting the wrong care in the wrong place.
According to CFHI, diseases such as chronic obstructive pulmonary disease (COPD) are placing a
growing strain on Canadas healthcare system. COPD is a chronic and progressive lung disease that
includes bronchitis and emphysema, and is characterized by debilitating breathlessness. It is
primarily caused by smoking. Of all chronic diseases, COPD is the number one reason for
hospitalizations in Canada, accounting for the largest number of return visits to emergency
departments. COPD also generates the highest volume of hospital readmissions.
CFHI today announced new results from a national initiative that shows hospitalizations due to
COPD can be decreased by up to 80 percent when healthcare is provided to patients and their
families at home. This transformational approach not only improves quality of care, but would also
avoid 68,500 emergency department visits, 44,100 hospitalizations and 400,000 bed days - saving
$688 million in hospital costs over the next five years.
A conservative estimate finds that about 800,000 Canadians live with COPD, yet people with
advanced COPD are among the highest users of Canadas hospital resources. One in four
Canadians (25 percent) over age 35 are expected to develop the disease in their lifetime, meaning
the situation is forecast to worsen in coming years.
To demonstrate how care at home can transform the way chronic illnesses are treated and
managed, CFHI spread across Canada an innovative community-outreach program to better
manage COPD first developed in Halifax.

We knew this was coming, says CFHI Vice-President, Programs, Stephen Samis. Rising rates of
chronic disease are straining our healthcare resources and staying the course is not an option.
Canada continues to operate a healthcare system designed in the 1960s that focuses on expensive
acute care rather than helping people manage their chronic diseases in the community.
The Solution: Care Closer to Home
CFHI, in collaboration with Boehringer Ingelheim (Canada) Ltd. (BICL), supported 19 hospitals from
every Canadian province to provide more effective, efficient and coordinated care to patients living
with advanced COPD and their families.
Healthcare teams identified patients who visited emergency departments or were hospitalized with
advanced COPD, and then invited them into a supportive program that provided them with written
action plans for managing their disease. This included a phone call after they were discharged
home; at-home self-management education and psychosocial support; and advance care planning
when needed. Patients in the program were also given a telephone number to call for support.
The program, known as the INSPIRED collaboration, has enrolled 885 patients across Canada. For
146 of those patients who had participated in the program for a three- month period, their
hospitalizations decreased by 80 percent. Patients also reported greater self-confidence, improved
symptom management and a return to daily activities such as climbing stairs, exercising, travelling

and returning to work. Family members and healthcare providers say that this program has improved
care for patients providing them with the support they need as they transition from hospital to
home, and the information they need to manage their illness. Patients say this program gave them
their lives back.
The INSPIRED collaboration has demonstrated that we can transform the way chronic illnesses are
treated and managed, says Richard Mole, President and CEO, Boehringer Ingelheim (Canada) Ltd.
Patients need access to the best and most streamlined care possible, and that means finding ways
to apply this model to other disease areas so that more Canadians can benefit.
Significant Cost Savings
An independent analysis carried out by RiskAnalytica concluded that further expanding the
CFHI/BICL INSPIRED collaboration would benefit 14,000 Canadians a year and save $688 million in
hospital costs over the coming five years. For every $1 invested in the program, $21 in hospitalbased costs could be prevented.
These impressive results are for one chronic disease COPD. If the same approach were taken for
other chronic illnesses such as congestive heart failure, it could save Canada`s healthcare system
billions of dollars each year, says CFHIs Mr. Samis. The proof is in the results with patients,
providers of care and hospital budgets seeing real benefits from this program.
Call-to-Action
CFHI is calling on governments and healthcare providers to work with them to scale-up the COPD
collaboration, and move towards community-based healthcare for other diseases so that every
Canadian can benefit from a person-centred approach to care. Materials are freely available on the
CFHI website for organizations that want to deliver an INSPIRED Approach to COPD care.
For more information, or to get involved, please visit:

CFHI Website

Video

RiskAnalytica Report

Regional Backgrounders:

Atlantic Canada

Quebec

Ontario

Western Canada

About CFHI
The Canadian Foundation for Healthcare Improvement identifies proven innovations and accelerates
their spread across Canada, improving patient care, the health of Canadians and value-for-money.

These innovations could save healthcare budgets over $1 billion per year. CFHI is a not-for-profit
organization funded by Health Canada. Visit cfhi-fcass.ca for more information.
The views expressed herein do not necessarily represent the views of Health Canada.
About Boehringer Ingelheim
The Boehringer Ingelheim group is one of the worlds 20 leading pharmaceutical companies.
Headquartered in Ingelheim, Germany, Boehringer Ingelheim operates globally with 145 affiliates
and a total of more than 47,500 employees. The focus of the family-owned company, founded in
1885, is researching, developing, manufacturing and marketing new medications of high therapeutic
value for human and veterinary medicine. Social responsibility is an important element of the
corporate culture at Boehringer Ingelheim. This includes worldwide involvement in social projects,
such as the initiative Making More Health and caring for employees. Respect, equal opportunities
and reconciling career and family form the foundation of the mutual cooperation. In everything it
does, the company focuses on environmental protection and sustainability. In 2015, Boehringer
Ingelheim achieved net sales of about 14.8 billion euros. R&D expenditure corresponds to 20.3
percent of its net sales. The Canadian headquarters of Boehringer Ingelheim was established in
1972 in Montreal, Quebec and is now located in Burlington, Ontario. Boehringer Ingelheim employs
approximately 600 people across Canada.