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- Title
A pulmonary rehabilitation program reduces hospitalizations in chronic obstructive pulmonary disease patients: A cost-effectiveness study.
- Authors
Toubes-Navarro, Maria; Gude-Sampedro, Francisco; Álvarez-Dobaño, José; Reyes-Santias, Francisco; Rábade-Castedo, Carlos; Rodríguez-García, Carlota; Lado-Baleato, Óscar; Lago-Fidalgo, Raquel; Sánchez-Martínez, Noelia; Ricoy-Gabaldón, Jorge; Casal-Mouriño, Ana; Abelleira-Paris, Romina; Riveiro-Blanco, Vanessa; Zamarrón-Sanz, Carlos; Rodríguez-Núñez, Nuria; Lama-López, Adriana; Ferreiro-Fernández, Lucía; Valdés-Cuadrado, Luis
- Abstract
BACKGROUND: Although pulmonary rehabilitation (PR) is recommended in patients with chronic obstructive pulmonary disease (COPD), there is a scarcity of data demonstrating the cost-effectiveness and effectiveness of PR in reducing exacerbations. METHODS: A quasi-experimental study in 200 patients with COPD was conducted to determine the number of exacerbations 1 year before and after their participation in a PR program. Quality of life was measured using the COPD assessment test and EuroQol-5D. The costs of the program and exacerbations were assessed the year before and after participation in the PR program. The incremental cost-effectiveness ratio (ICER) was estimated in terms of quality-adjusted life years (QALYs). RESULTS: The number of admissions, length of hospital stay, and admissions to the emergency department decreased after participation in the PR program by 48.2%, 46.6%, and 42.5%, respectively (P < 0.001 for all). Results on quality of life tests improved significantly (P < 0.001 for the two tests). The cost of PR per patient and the cost of pre-PR and post-PR exacerbations were €1867.7 and €7895.2 and €4201.9, respectively. The PR resulted in a cost saving of €1826 (total, €365,200) per patient/year, and the gain in QALYs was+0.107. ICER was −€17,056. The total cost was <€20,000/QALY in 78% of patients. Conclusions: PR contributes to reducing the number of exacerbations in patients with COPD, thereby slowing clinical deterioration. In addition, it is cost-effective in terms of QALYs.
- Subjects
SPAIN; OBSTRUCTIVE lung disease treatment; MEDICAL rehabilitation; LENGTH of stay in hospitals; LUNG diseases; RESEARCH methodology; MEDICAL care costs; TERTIARY care; HOSPITAL care; COST effectiveness; QUALITY of life; QUESTIONNAIRES; DESCRIPTIVE statistics; ECONOMIC aspects of diseases; DISEASE exacerbation; QUALITY-adjusted life years; EVALUATION
- Publication
Annals of Thoracic Medicine, 2023, Vol 18, Issue 4, p190
- ISSN
1817-1737
- Publication type
Article
- DOI
10.4103/atm.atm_70_23