Short-stay in-patient rehabilitation of elderly patients with chronic obstructive pulmonary disease: prospective study.

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.