1. A pulmonary rehabilitation program reduces hospitalizations in chronic obstructive pulmonary disease patients: A cost-effectiveness study.
- Author
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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, and Valdés-Cuadrado, Luis
- Subjects
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 - 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. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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