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Nov. 12, 2018 – According to new research, only a tiny fraction of patients hospitalized for COPD or chronic obstructive pulmonary disease participate in a pulmonary rehabilitation program after hospitalization, although these programs are recommended and Medicare pays for it. published online in Annals of the American Thoracic Society .
In "Participation in Pulmonary Rehabilitation After Hospitalization for COPD Among Medicare Beneficiaries", Kerry A. Spitzer, Ph.D., MPA, and his co-authors, report that in 2012, 1 Only 9% of patients with COPD had started pulmonary rehabilitation within six months of leaving. being hospitalized for an exacerbation of COPD. This is despite the fact that two years ago Medicare's policy had been modified to cover pulmonary rehabilitation services, offering for the first time pulmonary rehabilitation to millions of American patients.
COPD is a chronic disease and the fourth leading cause of death in the country. American pulmonary rehabilitation includes exercises, self-management tips, nutrition counseling and emotional support. Despite its demonstrated benefits, a study commissioned by ATS and conducted by Wakefield Research found that 62% of people diagnosed with COPD had never heard of pulmonary rehabilitation.
Adaptive intervention has been shown to improve physical and psychological well-being and quality of life. Other studies have shown that pulmonary rehabilitation reduces exacerbations of COPD often leading to hospitalization. The clinical guidelines recommend that patients begin pulmonary rehabilitation within three weeks of discharge from the hospital.
According to the study's lead author Peter Lindenauer, MD, MSc, Baystate Hospital Center Hospitalist and Director of the Institute for Healthcare Delivery and Population Science at the University of Mbadachusetts Medical School, there is growing recognition of the benefits of pulmonary rehabilitation.
While hospitals and health systems, such as ours, redouble their efforts to keep COPD patients healthy and exclude them from the hospital, we prioritized patient registration. "We are seeing improved readmission rates in patients with COPD."
After reviewing the records of 223,832 inpatients for COPD in 2012, the researchers found:
- 4,225 (1.9%) received pulmonary rehabilitation within six months of discharge from the hospital.
- 6,111 (2.7%) benefited from pulmonary rehabilitation in the year following their discharge from hospital.
- Whites, men, younger patients and those receiving home oxygen were more likely to receive pulmonary rehabilitation.
- Smokers and people living more than 15 km from a pulmonary rehabilitation program, belonging to socio-economic disadvantaged groups and facing other chronic diseases and previous hospitalizations were less likely to benefit from pulmonary rehabilitation.
- Of those who started pulmonary rehabilitation, more than half completed at least 16 sessions. Medicare will generally support up to 36 sessions.
The limitations of the study include the fact that the researchers were unable to determine if the low rates of pulmonary rehabilitation utilization were due to a lack of referral by physicians, to the choice patients not to attend or a combination of both. factors.
Dr. Spitzer, lead author of the study and principal coordinator of clinical research at Baystate, believes more research is needed to understand why patients are not receiving pulmonary rehabilitation.
"Unfortunately, many patients face many barriers, such as family responsibilities or transportation, and participation rates are particularly low among vulnerable populations," she said. "We have learned a lot about how hospitals can help meet these challenges."
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About Annals of the American Thoracic Society (AnnalsATS)
The AnnalsATS is a peer-reviewed journal published by the American Thoracic Society. The Journal provides up-to-date and authoritative coverage of pulmonary and respiratory sleep medicine in adults and children, as well as intensive care in adults. The Journal encompbades the content that applies to clinical practice, training and continuing education of clinical specialists and the advancement of public health. Publisher: David Lederer, MD, MS, Associate Professor of Medicine and Epidemiology and Associate Division Head for Clinical and Translational Research at Columbia University.
About the American Thoracic Society
Founded in 1905, the American Thoracic Society is the leading medical badociation in the world dedicated to the advancement of pulmonary care, critical care and sleep. The company has more than 16,000 members fighting against respiratory diseases worldwide through research, education, patient care and advocacy. The ATS publishes three newspapers, the American Journal of Respiratory and Critical Care Medicine the American Journal of Respiratory Cells and Molecular Biology and the Annals of the American Thoracic Society .
ATS will hold its 2019 International Conference from May 17-22 in Dallas, Texas, where world-renowned experts will share the latest scientific research and the latest clinical advances in pneumology, critical care and sleep.
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