Chest
Clinical InvestigationsHospitalization Needs During an Outpatient Rehabilitation Program for Severe Chronic Airway Obstruction
Section snippets
Materials and Methods
Over a two-year period beginning in 1966, patients with chronic airway obstruction were accepted into a new comprehensive program of care designed to provide physical rehabilitation for patients with marked disability.1 The patients met the following criteria for selection: (1) a clinical diagnosis of emphysema, chronic bronchitis, or both, by the established clinical definitions of the American Thoracic Society10 and the Ciba Symposium;11 (2) absence of other significant pulmonary disease,
Results
The 44 four-year survivors were divided into two groups; group 1 consisted of 14 patients who had hospitalization(s) in the year before entry into the program, and group 2 consisted of 30 patients who had no hospitalizations during the year before entry. The results of the spirometric tests performed on entering the program were compared between groups 1 and 2 and the remaining 69 patients of the original group of 113 who received the questionnaire regarding days of hospitalization (Table 1).
Discussion
Our study does not contain a matched control group without therapy. When initiating the treatment program, we did not believe that we could deny treatment to severely symptomatic patients seeking relief and then follow them as a control group. The decision to use the patient's experience in the year before therapy as the “control,” despite its shortcomings, seemed the best compromise when considering the difficult ethical and scientific questions involved. This method raises the possibility
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Cited by (47)
Pulmonary Rehabilitation
2008, Essentials of Physical Medicine and RehabilitationPulmonary Rehabilitation
2008, Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, Pain, and Rehabilitation, Second EditionThe effects of 1 year of specific inspiratory muscle training in patients with COPD
2005, ChestCitation Excerpt :In addition, these improvements were translated by the patients to a better quality of life following training. A previous uncontrolled and retrospective study29 found a significant decrease in hospitalization days after a rehabilitation program. However, no such differences in hospitalization days were demonstrated by others.30
Results at 1 year of outpatient multidisciplinary pulmonary rehabilitation: A randomised controlled trial
2000, LancetCitation Excerpt :About 50% of outpatents with chronic obstructive pulmonary disease at our hospial before the study were admitted at least once in each year. Previous retrospective studies have shown a 38–55% decrease in days in hospital after rehabilitation.20–22 Realistically, we expected a 25% decrease in admission rate, which would have an important effect on health service resources.
Direct medical cost of chronic obstructive pulmonary disease in the U.S.A.
2000, Respiratory Medicine
Supported by grants HE05933 and HL07085.
Manuscript received September 22; revision accepted April 7.