Effectiveness and Economic Evaluation of Hospital-Outreach Pulmonary Rehabilitation for Patients with Chronic Obstructive Pulmonary Disease
© 2020 Zhang et al..
Objective: Hospital-outreach pulmonary rehabilitation (PR) can improve health status and reduce health-care utilization by patients with chronic obstructive pulmonary disease (COPD). However, its long-term effects and costs versus benefits are still not clear. This study was conducted to develop, deliver, and evaluate the effects and monetary savings of a hospital-outreach PR program for patients with COPD.
Methods: A randomized controlled trial was conducted. Patients with COPD (n=208) were randomly assigned to the hospital-outreach PR program (treatment) or treatment as usual (control). The treatment group received a 3-month intensive intervention, including supervised physical exercise, smoking cessation, self-management education, and psychosocial support, followed by long-term access to a nurse through telephone follow-up and home visits up to 24 months. The control group received routine care, including discharge education and a self-management education brochure. Main outcomes were collected at 3, 6, 12, and 24 -months postrandomization. Primary outcomes included health-care utilization (ie, readmission rates, times, and days, and emergency department visits) and medical costs. Secondary outcomes included lung function (ie, FEV1, FEV1% predicted, FVC), dyspnea (mMCR), exercise capacity (6MWD), impact on quality of life (CAT), and self-management (CSMS).
Results: At the end of 24 months, 85 (81.7%) in the treatment group and 89 (85.6%) in the control group had completed the whole program. Compared with the control group, patients in the treatment group had lower readmission rates, times, and days at 6 and 12 months and during 12-24 months. Regarding costs during the 2 years, the program achieved CN¥3,655.94 medical savings per patient per year, and every ¥1 spent on the program led to ¥3.29 insavings. Patients in the treatment group achieved improvements in FEV1, FEV1% predicted, exercise capacity, and self-management. It also achieved relief of dyspnea symptoms and improvement in COPD's impact on quality of life.
Conclusion: The hospital-outreach PR program for patients with COPD achieved reductions in health-care utilization, monetary savings, and improvements in patient health outcomes. The effects of the program were sustained for at least 2 years.
Trial Registration: This trial was registered at the Chinese Clinical Trial Registry (ChiCTR-TRC-14005108).
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:15 |
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| Enthalten in: |
International journal of chronic obstructive pulmonary disease - 15(2020) vom: 28., Seite 1071-1083 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Zhang, Aidi [VerfasserIn] |
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| Links: |
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| Themen: |
Case Reports |
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| Anmerkungen: |
Date Completed 25.06.2021 Date Revised 11.11.2023 published: Electronic-eCollection Citation Status MEDLINE |
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| doi: |
10.2147/COPD.S239841 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 100 | 1 | |a Zhang, Aidi |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Effectiveness and Economic Evaluation of Hospital-Outreach Pulmonary Rehabilitation for Patients with Chronic Obstructive Pulmonary Disease |
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| 500 | |a Date Revised 11.11.2023 | ||
| 500 | |a published: Electronic-eCollection | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2020 Zhang et al. | ||
| 520 | |a Objective: Hospital-outreach pulmonary rehabilitation (PR) can improve health status and reduce health-care utilization by patients with chronic obstructive pulmonary disease (COPD). However, its long-term effects and costs versus benefits are still not clear. This study was conducted to develop, deliver, and evaluate the effects and monetary savings of a hospital-outreach PR program for patients with COPD | ||
| 520 | |a Methods: A randomized controlled trial was conducted. Patients with COPD (n=208) were randomly assigned to the hospital-outreach PR program (treatment) or treatment as usual (control). The treatment group received a 3-month intensive intervention, including supervised physical exercise, smoking cessation, self-management education, and psychosocial support, followed by long-term access to a nurse through telephone follow-up and home visits up to 24 months. The control group received routine care, including discharge education and a self-management education brochure. Main outcomes were collected at 3, 6, 12, and 24 -months postrandomization. Primary outcomes included health-care utilization (ie, readmission rates, times, and days, and emergency department visits) and medical costs. Secondary outcomes included lung function (ie, FEV1, FEV1% predicted, FVC), dyspnea (mMCR), exercise capacity (6MWD), impact on quality of life (CAT), and self-management (CSMS) | ||
| 520 | |a Results: At the end of 24 months, 85 (81.7%) in the treatment group and 89 (85.6%) in the control group had completed the whole program. Compared with the control group, patients in the treatment group had lower readmission rates, times, and days at 6 and 12 months and during 12-24 months. Regarding costs during the 2 years, the program achieved CN¥3,655.94 medical savings per patient per year, and every ¥1 spent on the program led to ¥3.29 insavings. Patients in the treatment group achieved improvements in FEV1, FEV1% predicted, exercise capacity, and self-management. It also achieved relief of dyspnea symptoms and improvement in COPD's impact on quality of life | ||
| 520 | |a Conclusion: The hospital-outreach PR program for patients with COPD achieved reductions in health-care utilization, monetary savings, and improvements in patient health outcomes. The effects of the program were sustained for at least 2 years | ||
| 520 | |a Trial Registration: This trial was registered at the Chinese Clinical Trial Registry (ChiCTR-TRC-14005108) | ||
| 650 | 4 | |a Case Reports | |
| 650 | 4 | |a Randomized Controlled Trial | |
| 650 | 4 | |a chronic obstructive pulmonary disease | |
| 650 | 4 | |a effects | |
| 650 | 4 | |a hospital-outreach intervention | |
| 650 | 4 | |a pulmonary rehabilitation | |
| 650 | 4 | |a savings | |
| 700 | 1 | |a Wang, Lianhong |e verfasserin |4 aut | |
| 700 | 1 | |a Long, Lu |e verfasserin |4 aut | |
| 700 | 1 | |a Yan, Jin |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Chun |e verfasserin |4 aut | |
| 700 | 1 | |a Zhu, Sucui |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Xiaowan |e verfasserin |4 aut | |
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| 773 | 1 | 8 | |g volume:15 |g year:2020 |g day:28 |g pages:1071-1083 |
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