Reduction in hospitalisation following pulmonary rehabilitation in patients with COPD.
OBJECTIVE
Pulmonary rehabilitation (PR) improves exercise capacity and health-related quality of life (HRQoL), and reduces health care utilisation. This study quantified outcomes of a PR program over a 6-year period and determined the effects of PR on hospitalisation.


METHODS
Patients with chronic obstructive pulmonary disesae (COPD) who entered an 8-week outpatient PR program from 1998 to 2003 were included. Functional exercise capacity (6-minute walk distance [6MWD]) and HRQoL (Chronic Respiratory Disease Questionnaire) were measured before and following PR. The number of hospital admissions and total bed-days due to a COPD exacerbation in the 12 months before and following PR were recorded.


METHODS
Physiotherapy Department, Sir Charles Gairdner Hospital, Western Australia.


RESULTS
187 (73%) of the 256 patients who entered PR completed the program. Improvements in 6MWD (404.2 +/- 114.6 m to 439.6 +/- 115.0m, P < 0.001) and HRQoL (4.1 +/- 0.9 points per item to 4.9 +/- 0.9 points per item, P < 0.001) occurred following PR. There was a 46% reduction in the number of patients admitted to hospital (71 to 38) with a COPD exacerbation and a 62% reduction in total bed-days (1131 to 432) following PR.


CONCLUSIONS
Pulmonary rehabilitation provided in an Australian teaching hospital was associated with a reduction in COPD hospitalisation, and the resultant savings outweighed the costs of providing the program.
Cecins
Nola
N
Physiotherapy Department, Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, Perth, WA 6009, Australia. Nola.Cecins@health.wa.gov.au
Geelhoed
Elizabeth
E
Jenkins
Sue C
SC
D000368:Aged; D017046:Cost Savings; D005081:Exercise Therapy; D005260:Female; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data*; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D010044:Outpatient Clinics, Hospital / Q000458:organization & administration*; D015397:Program Evaluation; D029424:Pulmonary Disease, Chronic Obstructive / Q000191:economics / Q000534:rehabilitation*; D011788:Quality of Life; D018434:Sickness Impact Profile