title: Pulmonary Rehabilitation Utilization in Older Adults With Chronic Obstructive Pulmonary Disease, 2003 to 2012.
abstract: OBJECTIVE
  To assess the trends in pulmonary rehabilitation (PR) utilization and factors associated with its use in older adults with chronic obstructive pulmonary disease (COPD).
  
  
  METHODS
  We examined data for Medicare beneficiaries with COPD who received PR from January 1, 2003, to December 31, 2012. Persons with COPD were identified by (1) ≥2 outpatient visits >30 days apart within 1 year with an encounter diagnosis of COPD or (2) an acute care hospitalization with COPD as the primary diagnosis or a primary diagnosis of acute respiratory failure with a secondary discharge diagnosis of COPD. PR utilization was the study outcome identified by health care common procedure coding system codes G0237, G0238, G0239, and G0424 (after year 2010) or current procedural terminology codes (97001, 97003, 97110, 97116, 97124, 97139, 97150, 97530, 97535, and 97537) in a calendar year.
  
  
  RESULTS
  Patients with COPD who received PR increased from 2.6% in 2003 to 3.7% in 2012 (P = .001). In a multivariable analysis, factors associated with receipt of PR were younger age, non-Hispanic white race, high socioeconomic status, multiple comorbidities (OR = 1.20; 95% CI = 1.13-1.27), and evaluation by a pulmonary physician (OR = 2.23; 95% CI = 2.13-2.33). Increased use of PR was attributed to prior users rather than new users of PR.
  
  
  CONCLUSIONS
  Utilization of PR during the study period increased only 1.1% in these Medicare beneficiaries with COPD and remained low.
authors.affiliation: Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine (Drs Nishi and Sharma and Mr Zhang), and Sealy Center on Aging (Drs Kuo and Sharma), University of Texas Medical Branch-Galveston, Galveston.
authors.forename: Shawn P E
authors.initials: SP
authors.lastname: Nishi
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.forename: Yong-Fang
authors.initials: YF
authors.lastname: Kuo
authors.forename: Gulshan
authors.initials: G
authors.lastname: Sharma
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D006278:Medicare / Q000706:statistics & numerical data*; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology* / Q000534:rehabilitation*; D015272:Pulmonary Medicine; D012046:Rehabilitation / Q000639:trends; D012923:Social Class; D014481:United States