Pulmonary rehabilitation in the acute inpatient rehabilitation hospital.
In closing, pulmonary rehabilitation in an inpatient rehabilitation hospital is not a new idea, but is now becoming more popular as the burden of care shifts away from the acute care hospital. Pulmonary rehabilitation has been demonstrated to be cost-effective, improve quality of life, and decrease the number of future hospital days for the patient. A few surveys have shown, however, that only 5% of pulmonary rehabilitation programs serviced inpatients in a rehabilitation hospital, and only 1% of 283 programs had a physiatrist as the medical director of the pulmonary rehabilitation program. Nine percent of programs surveyed serviced inpatients in rehabilitation units within the acute care hospital. Clearly, the majority of pulmonary rehabilitation programs are on an outpatient basis, and many of these are located within the walls of a rehabilitation hospital. Effective pulmonary rehabilitation can be done in the home setting when combined with outpatient therapy visits over a 12-week duration. The spectrum of pulmonary rehabilitation will continue to evolve into the twenty-first century, and clearly the rehabilitation hospital will be part of that change. Whether caring for very elderly COPD patients who are too debilitated to return home from the acute care hospital or managing ventilator-dependent patients with COPD, spinal cord injury, or neuromuscular disease, the IPR team and the rehabilitation hospital will have to demonstrate cost-effective outcomes. Physiatrists should play a major role in this evolution, on both a patient-benefit level and legislative level, to increase awareness of pulmonary rehabilitation.
Glassman
S J
SJ
Department of Physical Medicine and Rehabilitation, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, New Brunswick, USA.
D018166:Health Care Reform / Q000331:legislation & jurisprudence*; D006760:Hospitalization; D006801:Humans; D007297:Inpatients; D008171:Lung Diseases / Q000534:rehabilitation*; D014481:United States