title: The effect of pulmonary rehabilitation on healthcare utilization in chronic obstructive pulmonary disease: The Northeast Pulmonary Rehabilitation Consortium.
abstract: Although pulmonary rehabilitation results in improvement in multiple outcome areas, relatively few studies in the United States have evaluated its effect on healthcare utilization. This study compared aspects of healthcare utilization during the year before to the year after outpatient pulmonary rehabilitation in patients with chronic obstructive pulmonary disease referred to 11 hospital-based centers in Connecticut and New York. Utilization data from 128 of 132 patients who originally gave informed consent were evaluated; their mean age was 69 years and their forced expiratory volume in 1 second was 44% of predicted. Forty-five percent had 1 or more hospitalizations in the year before beginning pulmonary rehabilitation. In the year after pulmonary rehabilitation, there were 0.25 fewer total hospitalizations (P = .017) and 2.18 fewer hospital days (P = .015) per patient and 271 fewer hospital days for the group. Hospitalizations for respiratory reasons also decreased significantly. Most of the reduction in hospital utilization was due to a decrease in intensive care unit days. The number of physician visits decreased by 2.4 in the year after pulmonary rehabilitation (P < .0001); most of this reduction was due to decreased visits to primary care providers. The estimated costs/charges for the aspects of healthcare utilization that we studied decreased by a mean of 4,694 dollars and a median of 390 dollars (P = .0002). This study suggests that pulmonary rehabilitation leads to a reduction in healthcare utilization.
authors.affiliation: Beth Israel Medical Center, New York, NY, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Raskin
authors.forename: Peter
authors.initials: P
authors.lastname: Spiegler
authors.forename: Corliss
authors.initials: C
authors.lastname: McCusker
authors.forename: Richard
authors.initials: R
authors.lastname: ZuWallack
authors.forename: Mara
authors.initials: M
authors.lastname: Bernstein
authors.forename: Jim
authors.initials: J
authors.lastname: Busby
authors.forename: Pat
authors.initials: P
authors.lastname: DiLauro
authors.forename: Karen
authors.initials: K
authors.lastname: Griffiths
authors.forename: Margaret
authors.initials: M
authors.lastname: Haggerty
authors.forename: Lynne
authors.initials: L
authors.lastname: Hovey
authors.forename: Donna
authors.initials: D
authors.lastname: McEvoy
authors.forename: Jane Z
authors.initials: JZ
authors.lastname: Reardon
authors.forename: Kim
authors.initials: K
authors.lastname: Stavrolakes
authors.forename: Rebecca
authors.initials: R
authors.lastname: Stockdale-Woolley
authors.forename: Peggy
authors.initials: P
authors.lastname: Thompson
authors.forename: Grace
authors.initials: G
authors.lastname: Trimmer
authors.forename: Louise
authors.initials: L
authors.lastname: Youngson
mesh_terms: D000368:Aged; D003237:Connecticut; D005260:Female; D005541:Forced Expiratory Volume; D017048:Health Care Costs; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009518:New York; D009819:Office Visits / Q000191:economics / Q000706:statistics & numerical data*; D017063:Outcome Assessment, Health Care; D010044:Outpatient Clinics, Hospital / Q000191:economics / Q000706:statistics & numerical data; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology / Q000534:rehabilitation*; D012047:Rehabilitation Centers / Q000191:economics / Q000706:statistics & numerical data*; D012129:Respiratory Function Tests