Impact of Pulmonary Rehabilitation on Hospitalizations for Chronic Obstructive Pulmonary Disease Among Members of an Integrated Health Care System. Issue 5 (September 2015)

• Record Type: Journal Article
• Authors: Nguyen, Huong Q.; Harrington, Annie; Liu, In-Lu Amy; Lee, Janet S.; Gould, Michael K.
• Is Part Of: Journal of cardiopulmonary rehabilitation and prevention. Volume 35:Issue 5(2015)
• Publication Date: 2015-09
• Subjects: chronic obstructive pulmonary disease -- health care resource utilization -- hospitalizations -- pulmonary rehabilitation; Cardiopulmonary system -- Diseases -- Patients -- Rehabilitation -- Periodicals; Cardiopulmonary system -- Diseases -- Prevention -- Periodicals; 616.103
• DOI: 10.1097/HCR.0000000000000128
• Languages: English
• ISSNs: 1932-7501

Abstract

Abstract : PURPOSE: The evidence regarding the effects of pulmonary rehabilitation (PR) on health care resource use remains limited. This retrospective study evaluated the effects of PR on the primary outcome of all-cause hospitalizations and secondary outcomes of other health care use, exercise capacity, health-related quality of life (HRQOL), and body weight in patients with chronic obstructive pulmonary disease (COPD) in a large integrated health care system. METHODS: The PR cohort included 558 patients with a COPD diagnosis, age ≥ 40 years, who were treated with a bronchodilator or steroid inhaler, participated in 1 of 13 PR programs between January 1, 2008, and August 1, 2013, and were continuously enrolled in the health plan ≥ 12 months prior to and after PR. Two non-PR control cohorts were assembled for comparison. Data were extracted from electronic health records. The 6-minute walk test and St. George's Respiratory Questionnaire results were available for a subset. RESULTS: The proportion of patients who were hospitalized 12 months post-PR was lower compared with the 12 months prior (37% vs 45%, P = .001) while emergency department use was not different (52% vs 54%). Patients who declined PR for logistical reasons had a 40% higher risk of hospitalization than PR participants (relative risk = 1.40, 95% CI: 0.96-2.06, P = .08). There were significant improvements in the 6-minute walk test distance (+43 m) and the St. George's Respiratory Questionnaire total score (−9.6 points) but minimal changes in weight. CONCLUSIONS: Our finding that participation in PR is associated with reductions in hospitalizations corroborates previous studies. A notable strength of this study is the capture of complete utilization data. Abstract : Electronic data from a large integrated health care system were used to determine the effects of pulmonary rehabilitation on hospitalizations in chronic obstructive pulmonary disease. The results of this contemporary study confirm findings of previous studies that participation is associated with reductions in all-cause hospitalizations in the 12 months after completing rehabilitation.