Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Bermingham SL. Pulmonary rehabilitation setting for adults with chronic obstructive pulmonary disease (COPD): an economic rapid review. Toronto: Health Quality Ontario (HQO). Economic Rapid Review. 2015 Authors' conclusions This literature review could not determine whether hospitals or home and community locations are the most cost-effective setting for pulmonary rehabilitation programs for adults with COPD.
We identified only one published study that compared the costs and QALYs of pulmonary rehabilitation across different settings. The study showed that hospital-based pulmonary rehabilitation is more costly and more effective than community-based pulmonary rehabilitation. The resulting cost per QALY gained was £28,820 (equivalent to $65,800 in 2013 Canadian dollars).
The study was designed to be pragmatic, without overly strict inclusion criteria. Approximately 60% of patients in each arm completed each rehabilitation program. The cost of each program was similar and comprised a small proportion of the total cost for each group. The main difference in total cost was attributed to prescriptions, which were £824 more expensive in the hospital-based group. No reason for this difference was proposed.
The cause of the difference in QALYs is unclear. Improved quality of life in the hospital-based group could be due to a small increase in walking ability compared with the community-based group. However, it may also be due to the fact that quality of life was included as a secondary outcome and therefore the study was not powered to detect changes between groups for this outcome. Indexing Status Subject indexing assigned by CRD MeSH Community Health Services; Cost-Benefit Analysis; Delivery of Health Care; Home Care Services; Hospitalization; Humans; Pulmonary Disease, Chronic Obstructive; Quality-Adjusted Life Years; Rehabilitation Language Published English Country of organisation Canada English summary An English language summary is available. Address for correspondence Evidence Development and Standards, Health Quality Ontario, 130 Bloor Street West, 10th floor, Toronto, Ontario Canada M5S 1N5 Email: EDSinfo@hqontario.ca AccessionNumber 32015000490 Date abstract record published 15/04/2015 |