SESSION TYPE: Physiology/PFTs/ Rehabilitation II
PRESENTED ON: Monday, October 22, 2012 at 11:15 AM - 12:30 PM
PURPOSE: Early as well as late Pulmonary Rehabilitation (PR) are multidisciplinary therapies for treatment of chronic lung diseases. PR improves dyspnoea, physical endurance and quality of life. As since 2005, health insurance companies should pay for pulmonary rehabilitation programs that are accredited according to the Swiss guidelines for PR. New programs are assessed by two pulmonologists. Quality criteria include program structure, rehabilitation process and outcome measurements. Every program undergoes a recertification process every 2 years by a questionnaire. Actually, 10 in- and 56 outpatient-programs are accredited.
METHODS: For more than 10 years, the WG takes care of the quality of PR-programs. The recertification process includes the number of patients treated, diagnosis, complications and changes in program structure. Failure to reply to two consecutive questionnaires results in loss of accreditation. For the third assessment period of 2009/2010, almost all program directors answered the questionnaire.
RESULTS: In 2009/2010 respectively, 4727/5090 inpatients (IP) and 1232/1537 outpatients (OP) were treated. The return rate of the questionnaire was 98% (05/06: 77%; 07/08: 87%). As in 2007/2008 also in 2009/2010 most patients suffered from COPD (37%/37%), but patients with other diagnoses qualifying for PR were enrolled in the programs too. Especially one IP program treats mainly chronic asthmatic patients. As this program is responsible for 33% of the total number of IP, the percentage of COPD overall seems low. On exclusion of the mentioned program, the percentage of COPD for the 9 other IP programs rises to 48 % in both years. Acute exacerbations (all programs) occurred in 158/185, fatal complications in 16/23 cases. In average, more than 95 % (98 % IP; 83% OP) of the patients completed the programs (07/08: 92%).
CONCLUSIONS: Switzerland has a widespread, growing network of PR programs. Despite measurable improvement in quality of life of PR, the number of treated patients between 2005 and 2010 increased slowly. The main reason for PR was COPD but other diagnosis contribute for over 50% of all cases. The drop out rate for PR is considerably higher in the OP (17%/15%) than in the IP. (2%/2%). A possible reason could be lower compliance in OP. Dropout-rate in OP mostly due to personal reasons, 38%.
CLINICAL IMPLICATIONS: Feedback on certified PR programs
DISCLOSURE: The following authors have nothing to disclose: Werner Karrer, Leander Gonzalez, Martin Frey, Urs Lagler
No Product/Research Disclosure InformationLuzerner Hoehenklinik Montana, Crans-Montana, Switzerland