Annals of Thoracic Medicine (Jan 2023)

A pulmonary rehabilitation program reduces hospitalizations in chronic obstructive pulmonary disease patients: A cost-effectiveness study

  • Maria Elena Toubes-Navarro,
  • Francisco Gude-Sampedro,
  • José Manuel Álvarez-Dobaño,
  • Francisco Reyes-Santias,
  • Carlos Rábade-Castedo,
  • Carlota Rodríguez-García,
  • Óscar Lado-Baleato,
  • Raquel Lago-Fidalgo,
  • Noelia Sánchez-Martínez,
  • Jorge Ricoy-Gabaldón,
  • Ana Casal-Mouriño,
  • Romina Abelleira-Paris,
  • Vanessa Riveiro-Blanco,
  • Carlos Zamarrón-Sanz,
  • Nuria Rodríguez-Núñez,
  • Adriana Lama-López,
  • Lucía Ferreiro-Fernández,
  • Luis Valdés-Cuadrado

DOI
https://doi.org/10.4103/atm.atm_70_23
Journal volume & issue
Vol. 18, no. 4
pp. 190 – 198

Abstract

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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.

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