Display options
Cite
Morsø L, Jensen MS, von Plessen C, et al. Rehabilitation of Discharged Patients With Chronic Obstructive Pulmonary Disease-Are New Strategies Needed?. Health Serv Res Manag Epidemiol. 2017;4:2333392816687704doi: 10.1177/2333392816687704.
Morsø, L., Jensen, M. S., von Plessen, C., & Qvist, P. (2017). Rehabilitation of Discharged Patients With Chronic Obstructive Pulmonary Disease-Are New Strategies Needed?. Health services research and managerial epidemiology, 42333392816687704. https://doi.org/10.1177/2333392816687704
Morsø, Lars, et al. "Rehabilitation of Discharged Patients With Chronic Obstructive Pulmonary Disease-Are New Strategies Needed?." Health services research and managerial epidemiology vol. 4 (2017): 2333392816687704. doi: https://doi.org/10.1177/2333392816687704
Morsø L, Jensen MS, von Plessen C, Qvist P. Rehabilitation of Discharged Patients With Chronic Obstructive Pulmonary Disease-Are New Strategies Needed?. Health Serv Res Manag Epidemiol. 2017 Jan 12;4:2333392816687704. doi: 10.1177/2333392816687704. eCollection 2017. PMID: 28508012; PMCID: PMC5415270.
Copy Download .nbib Format: NLM
Share it on

Health Serv Res Manag Epidemiol. 2017 Jan 12;4:2333392816687704. doi: 10.1177/2333392816687704. eCollection 2017.

Rehabilitation of Discharged Patients With Chronic Obstructive Pulmonary Disease-Are New Strategies Needed?.

Health services research and managerial epidemiology

Lars Morsø, Morten Sall Jensen, Christian von Plessen, Peter Qvist

Affiliations

  1. Department for Regional Health Research, Centre for Quality, University of Southern Denmark, Odense, Denmark.

PMID: 28508012 PMCID: PMC5415270 DOI: 10.1177/2333392816687704

Abstract

BACKGROUND: Rehabilitation after hospital stay implies several benefits for patients with chronic obstructive pulmonary disease (COPD); still few patients are referred and participate in rehabilitation programs. We conducted a case study to investigate the effects of interventions targeting the referral, uptake, and completion for a program of early rehabilitation in the primary health-care sector.

METHODS: We undertook targeted initiatives to make patients participate in an individualized rehabilitation program with gradual increased intensity. After discharge, primary care COPD nurses and physiotherapists guided patients through progressing exercises in small groups online. Patients proceeded to class-based exercises, patient education and/or leisure activities, or continued telerehabilitation. We evaluated the effects of the intervention by assessing referral rates, completion, and readmission.

RESULTS: Sixteen (23% of discharged patients) patients were referred to rehabilitation. In comparison, only 1 (0.8%) in 131 patients from Vejle hospital was referred to Vejle hospital. Twelve patients completed rehabilitation, all having severe COPD. All started the program within 2 weeks and proceeded to the online-guided exercises within 4 weeks. Study data showed that after 30 days, 1 (6.3%) of the 16 patients in the rehabilitation program had been readmitted compared to 8 (14.8%) of 55 patients who were not referred. After 90 days, 2 (12.5%) and 11 (20.0%) patients were readmitted, respectively. The readmission rate showed a nonsignificant decline in patients participating in rehabilitation.

CONCLUSION: This case study showed that the referral rate of patients with COPD to early municipal rehabilitation is extremely low without a targeted effort and still insufficient in spite of a focused intervention. We showed that completion of a municipal rehabilitation program shortly after discharge is possible even for patients with severe COPD. The findings from our pilot study can guide further investigations into the effect of implementation strategies for handovers between health-care sectors to secure early-onset rehabilitation of patients with COPD.

Keywords: COPD; patient satisfaction; readmission; referral rates; rehabilitation

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

References

  1. Respir Med. 2012 Mar;106(3):374-81 - PubMed
  2. Lancet. 1997 May 24;349(9064):1498-504 - PubMed
  3. Int J Chron Obstruct Pulmon Dis. 2011;6:659-67 - PubMed
  4. Respir Med. 2009 Oct;103(10):1564-71 - PubMed
  5. Thorax. 2003 Jul;58(7):589-93 - PubMed
  6. Scand J Public Health. 2011 Jul;39(7 Suppl):22-5 - PubMed
  7. Clin Rehabil. 2007 Mar;21(3):212-21 - PubMed
  8. BMC Res Notes. 2012 Nov 23;5:652 - PubMed
  9. Thorax. 2012 Nov;67(11):957-63 - PubMed
  10. Med J Aust. 2004 Mar 15;180(6 Suppl):S57-60 - PubMed
  11. Cochrane Database Syst Rev. 2011 Oct 05;(10):CD005305 - PubMed
  12. Am J Med. 2004 Aug 1;117(3):182-92 - PubMed
  13. Physiother Can. 2010 Fall;62(4):368-73 - PubMed
  14. Thorax. 2010 May;65(5):423-8 - PubMed
  15. Chron Respir Dis. 2015 Feb;12(1):5-10 - PubMed
  16. J Thorac Dis. 2014 Nov;6(11):1586-96 - PubMed
  17. Am J Respir Crit Care Med. 2013 Feb 15;187(4):347-65 - PubMed
  18. Respir Med. 2006 Oct;100(10):1716-23 - PubMed
  19. COPD. 2009 Apr;6(2):79-81 - PubMed
  20. Br J Gen Pract. 2008 Oct;58(555):703-10 - PubMed
  21. Chron Respir Dis. 2011;8(2):89-99 - PubMed
  22. Can Respir J. 2011 Jul-Aug;18(4):216-20 - PubMed
  23. Scand J Public Health. 2011 Jul;39(7 Suppl):17-9 - PubMed
  24. Qual Health Res. 2011 Sep;21(9):1239-48 - PubMed
  25. Eur Respir J. 2006 Apr;27(4):788-94 - PubMed
  26. Prim Care Respir J. 2013 Sep;22(3):319-24 - PubMed
  27. Clin Chest Med. 2014 Jun;35(2):303-11 - PubMed
  28. Scand J Public Health. 2011 Jul;39(7 Suppl):30-3 - PubMed
  29. COPD. 2015 Apr;12(2):217-25 - PubMed

Publication Types