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Short-stay in-patient rehavilitation of elderly
patients with chronic obstrutive pulmonary disease: prospective
study
SPS Ip, YF Leung, KL Choy
Room 818, Grand Tower, 639 Nathan Road, Kowloon, Hong Kong
OBJECTIVES. To evaluate the effectiveness of a short-stay in-patient
rehabilitation programme.
DESIGN. Prospective case-control cohort study.
SETTING. Regional medical centre, Hong Kong.
PATIENTS. One hundred and thirty symptomatic elderly
patients with chronic obstructive pulmonary disease who had been
treated for an acute respiratory illness in 1998. They were divided
into two groups: the conventional treatment
group, which received no rehabilitation (n=65), and the rehabilitation
group (n=65).
INTERVENTION. A short-stay in-patient rehabilitation
programme was implemented, which included assessment, patient and
caregiver education, an exercise regimen, physiotherapy, occupational
therapy, and case conference.
MAIN OUTCOME MEASURES. Length of stay, hospital
re-admission rate, and admission-free interval.
RESULTS. The mean length of stay in the rehabilitation
ward was 6.2 days. The rate of hospital re-admission was significantly
higher in the conventional treatment group than in the rehabilitation
group, both within 28 days of discharge
home (relative risk=3.33; 95% confidence interval, 2.32-4.56; P=0.019)
and at 100 days after discharge (relative risk=2.47; 95% confidence
interval, 1.78-3.48; P<0.001). The admission-free interval was
significantly longer in the rehabilitation
group than in the conventional treatment group (1.13 years vs 0.86
years; P<0.001).
CONCLUSION. A short-stay in-patient rehabilitation
programme is effective in reducing hospital re-admission rates.
This type of rehabilitation service may be important for elderly
patients, as well as for patients with more advanced disease
and more functional deficits than others.
Hong Kong Med J 2004;10:312-8
Key words: Inpatients; Length of stay; Lung disease,
obstructive/rehabilitation; Outcome assessment (health care); Pulmonary
disease, chronic obstructive
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