A pulmonary rehabilitation program reduces hospitalizations in chronic obstructive pulmonary disease patients: A cost-effectiveness study.

Autor: Toubes-Navarro ME; Department of Pulmonology, University Clinical Hospital of Santiago de Compostela, Spain., Gude-Sampedro F; Department of Clinical Epidemiology, University Clinical Hospital of Santiago de Compostela, Spain., Álvarez-Dobaño JM; Interdisciplinary Group of research in Pulmonology, Institute of Sanitary research from Compostela, Spain.; University Clinical Hospital of Santiago de Compostela, Spain., Reyes-Santias F; Department of Human Resources and General Services, University Clinical Hospital of Santiago de Compostela, Spain., Rábade-Castedo C; Department of Pulmonology, University Clinical Hospital of Santiago de Compostela, Spain., Rodríguez-García C; Department of Pulmonology, University Clinical Hospital of Santiago de Compostela, Spain., Lado-Baleato Ó; Research Methods Group, Health Research Institute of Santiago de Compostela, Spain.; ISCIII Support Platforms for Clinical Research, Health Research Institute of Santiago de Compostela, Spain., Lago-Fidalgo R; Department of Clinical Epidemiology, University Clinical Hospital of Santiago de Compostela, Spain.; Mathematics University of Santiago de Compostela, Spain., Sánchez-Martínez N; Department of Clinical Epidemiology, University Clinical Hospital of Santiago de Compostela, Spain.; Mathematics University of Santiago de Compostela, Spain., Ricoy-Gabaldón J; Department of Pulmonology, University Clinical Hospital of Santiago de Compostela, Spain., Casal-Mouriño A; Department of Pulmonology, University Clinical Hospital of Santiago de Compostela, Spain., Abelleira-Paris R; Department of Pulmonology, University Clinical Hospital of Santiago de Compostela, Spain., Riveiro-Blanco V; Department of Pulmonology, University Clinical Hospital of Santiago de Compostela, Spain., Zamarrón-Sanz C; Department of Pulmonology, University Clinical Hospital of Santiago de Compostela, Spain., Rodríguez-Núñez N; Department of Pulmonology, University Clinical Hospital of Santiago de Compostela, Spain., Lama-López A; Department of Pulmonology, University Clinical Hospital of Santiago de Compostela, Spain., Ferreiro-Fernández L; Department of Pulmonology, University Clinical Hospital of Santiago de Compostela, Spain.; Interdisciplinary Group of research in Pulmonology, Institute of Sanitary research from Compostela, Spain., Valdés-Cuadrado L; Department of Pulmonology, University Clinical Hospital of Santiago de Compostela, Spain.; Interdisciplinary Group of research in Pulmonology, Institute of Sanitary research from Compostela, Spain.; Medicine University of Santiago de Compostela, Spain.
Jazyk: angličtina
Zdroj: Annals of thoracic medicine [Ann Thorac Med] 2023 Oct-Dec; Vol. 18 (4), pp. 190-198. Date of Electronic Publication: 2023 Oct 17.
DOI: 10.4103/atm.atm_70_23
Abstrakt: Background: Although pulmonary rehabilitation (PR) is recommended in patients with chronic obstructive pulmonary disease (COPD), there is a scarcity of data demonstrating the cost-effectiveness and effectiveness of PR in reducing exacerbations.
Methods: A quasi-experimental study in 200 patients with COPD was conducted to determine the number of exacerbations 1 year before and after their participation in a PR program. Quality of life was measured using the COPD assessment test and EuroQol-5D. The costs of the program and exacerbations were assessed the year before and after participation in the PR program. The incremental cost-effectiveness ratio (ICER) was estimated in terms of quality-adjusted life years (QALYs).
Results: The number of admissions, length of hospital stay, and admissions to the emergency department decreased after participation in the PR program by 48.2%, 46.6%, and 42.5%, respectively ( P < 0.001 for all). Results on quality of life tests improved significantly ( P < 0.001 for the two tests). The cost of PR per patient and the cost of pre-PR and post-PR exacerbations were €1867.7 and €7895.2 and €4201.9, respectively. The PR resulted in a cost saving of €1826 (total, €365,200) per patient/year, and the gain in QALYs was+0.107. ICER was -€17,056. The total cost was <€20,000/QALY in 78% of patients.
Conclusions: PR contributes to reducing the number of exacerbations in patients with COPD, thereby slowing clinical deterioration. In addition, it is cost-effective in terms of QALYs.
Competing Interests: There are no conflicts of interest.
(Copyright: © 2023 Annals of Thoracic Medicine.)
Databáze: MEDLINE
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