Patients who are hospitalized with chronic obstructive pulmonary disease rarely receive post-acute pulmonary rehabilitation. But greater participation in rehab would improve these patients’ health and longevity. It could also result in net cost savings for healthcare systems, investigators contend.
The researchers used an economic simulation model to estimate the cost-effectiveness of participation in pulmonary rehab after COPD hospitalization compared with no rehab, and quality-adjusted life expectancy (QALE). To do so, they examined research data published between 2001 and 2021. They found net cost savings and improvement in QALE across a range of probability and cost parameters.
At an estimated savings of $5,700 per patient per year, “universal utilization of pulmonary rehabilitation could result in savings for Medicare of $1 to $1.25 billion annually,” they reported.
“These findings suggest that stakeholders should identify policies to increase access and adherence to pulmonary rehabilitation for patients with COPD,” the authors wrote.
Low use, despite coverage
Yet rehab participation is low in this patient group.
Medicare began providing coverage for pulmonary rehab in 2010. Yet as of 2012, the utilization rate for pulmonary rehab among Medicare beneficiaries was only 4%, the researchers noted. The disease is a huge burden on the healthcare system, affects about 16 million Americans and is a leading cause of death.
“Given these findings, payers — particularly Medicare — should identify policies that would increase access and adherence to pulmonary rehabilitation programs for patients living with COPD,” the authors of the current study concluded.
COPD, an umbrella term for a group of lung diseases that obstruct air flow, is estimated to affect 24 million people in the United States, according to the researchers. More than a quarter of costs associated with the condition can be attributed to hospitalization for acute exacerbation. What’s more, fully one quarter of these patients are readmitted to the hospital within 30 days, they reported.
The study was published in JAMA Network Open.
40 percent of US older adults with COPD have poor access to pulmonary rehabilitation