Subsystem: Economics
Population Group: 45–64-year-olds in Sentinel town
Disease, Chronic Condition, or Injury: Chronic Obstructive Pulmonary Disease (COPD)
Primary Prevention (Actions
or interventions used to
reduce exposure or
vulnerability to a health issue
or concern prior to disease
onset or diagnosis. Think:
health promotion and
disease prevention)
Proposed Action or
Intervention:
Hosting monthly classes
aimed at smoking cessation
and prevention. The classes
should cover the dangers of
smoking and exposure to
secondhand smoke as well as
smoking cessation strategies.
Evidence-based rationale of
how this action or
intervention will decrease
healthcare costs.
The costs attributed to having
COPD were estimated to
reach $49 billion dollars by
2020 (CDC, 2018). An
estimated 85%-90% of all
cases of COPD are caused by
cigarette smoking. (American
Lung Association, 2021).
Preventing smoking is the
most effective way of
preventing COPD.
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Secondary Prevention
(Actions or interventions
used to detect or treat a
health issue/concern in early
stages to prevent progression
or recurrence. Think early
and periodic screenings.)
Proposed Action or
Intervention:
The clinic could offer free
smoking cessation supplies to
those at high risk of
developing COPD, and those
in early stages of COPD.
These patients should also
have vitamin D levels
checked, and supplemented
if <25nmol/L.
Evidence-based rationale of
how this action or
intervention will decrease
healthcare costs.
Preventing exacerbations of
COPD can greatly reduce
costs associated with the
disease. The most important
secondary prevention
intervention for COPD is
getting smokers with COPD to
quit once a diagnosis has
been confirmed (Halpin,
2014). Having vitamin D
levels greater than 25 nmol/L
can reduce the rate of
Tertiary Prevention (Actions
or interventions used to limit
disability and/or enhance
rehabilitation for a disease or
injury. Think rehabilitation,
occupational or physical
therapy.)
Proposed Action or
Intervention:
The clinic can develop a
pulmonary rehabilitation
program, enrolling patients
diagnosed with COPD to
attend 2 sessions weekly.
Evidence-based rationale of
how this action or
intervention will decrease
healthcare costs.
Participation in pulmonary
rehab has been associated
with reduced hospital
admissions, increased
physical performance, and
improved quality of life
(Kjærgaard et al., 2020).
 moderate to severe
exacerbations of COPD (BMJ
Best Practice, 2021).

References

American Lung Association Scientific and Medical Editorial Review Panel. (2021, March 5). What causes
COPD. American Lung Association. https://www.lung.org/lung-health-diseases/lung-disease-
lookup/copd/what-causes-copd.

BMJ Best Practice. (2021). Chronic obstructive pulmonary disease (COPD). Chronic obstructive pulmonary
disease (COPD) - Prevention | BMJ Best Practice US. https://bestpractice.bmj.com/topics/en-
us/7/prevention.

Centers for Disease Control and Prevention. (2018, February 21). COPD costs. Centers for Disease Control and
Prevention. https://www.cdc.gov/copd/infographics/copd-costs.html.

Halpin, D. M. G. (2009). Preventing chronic obstructive pulmonary disease. Expert Review of Respiratory
Medicine, 3(5), 449–452. https://doi.org/10.1586/ers.09.40

Kjærgaard, J., Juhl, C. B., Lange, P., & Wilcke, T. (2020). Adherence to early pulmonary rehabilitation after
COPD exacerbation and risk of hospital readmission: A secondary analysis of the COPD-exa-rehab
study. BMJ Open Respiratory Research, 7(1). https://doi.org/10.1136/bmjresp-2020-000582

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