In-hospital short-term training program for patients with chronic airway obstruction.
OBJECTIVE
To compare the functional benefits and relative costs of administering an intense short-term inpatient vs a longer outpatient pulmonary rehabilitation program (PRP) for patients with chronic airway obstruction (CAO).


METHODS
Retrospective case-control study.


METHODS
Pulmonary ward and outpatient clinic of a rehabilitation center.


METHODS
Forty-three patients (case subjects) selected on the basis of selection criteria were compared with control subjects matched to them for age, sex, FEV(1), and diagnosis of either COPD or asthma. Case subjects performed 10 to 12 daily sessions (5 sessions a week) of inpatient PRP; control subjects performed 20 to 24 sessions (3 sessions a week) of outpatient PRP.


METHODS
At baseline and after the PRP, an incremental exercise test was performed, including evaluation of dyspnea and leg fatigue by Borg scale (D and F, respectively) at each workload step. The cost of PRP was also evaluated.


RESULTS
Both PRPs resulted in similar significant improvements in cycloergometry peak workload (from 68 +/- 18 to 82 +/- 22 and from 75 +/- 17 to 87 +/- 27 W in case subjects and control subjects, respectively), isoload D (from 6.4 +/- 1.6 to 4.2 +/- 1.8 for case subjects and from 8.5 +/- 1.9 to 6.3 +/- 2.4 for control subjects) and isoload F (from 6.6 +/- 1.8 to 4.2 +/- 1.8 for case subjects and from 8.9 +/- 1.9 to 7.0 +/- 1.8 for control subjects). Although the single daily session was less expensive, the outpatient PRP total costs were greater because of the higher number of sessions and the cost of daily transportation.


CONCLUSIONS
In patients with CAO, a shorter inpatient PRP may result in improvement in exercise tolerance similar to a longer outpatient PRP but with lower costs. Whether a shorter outpatient PRP may get physiologic and clinical benefits, while further reducing costs, must be evaluated by future controlled, randomized, prospective studies.
Clini
E
E
Salvatore Maugeri Foundation IRCCS, Lung Function Unit, Scientific Institute of Gussago, Italy. eclini@qubisoft.it
Foglio
K
K
Bianchi
L
L
Porta
R
R
Vitacca
M
M
Ambrosino
N
N
D000553:Ambulatory Care / Q000191:economics; D000554:Ambulatory Care Facilities / Q000191:economics; D001249:Asthma / Q000191:economics / Q000503:physiopathology / Q000534:rehabilitation; D016022:Case-Control Studies; D003365:Costs and Cost Analysis; D005081:Exercise Therapy / Q000191:economics; D017079:Exercise Tolerance; D005260:Female; D005541:Forced Expiratory Volume; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000191:economics / Q000503:physiopathology / Q000534:rehabilitation*; D012132:Respiratory Muscles / Q000503:physiopathology; D012189:Retrospective Studies