Authors' recommendations: 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.

Project Status: Completed

Year Published: 2015

URL for published report: http://www.hqontario.ca/Portals/0/Documents/eds/rapid-reviews/qbp-copd-rehab-setting-20141311-en.pdf

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Canada

Organisation Name: Health Quality Ontario

Contact Address: Evidence Development and Standards, Health Quality Ontario, 130 Bloor Street West, 10th floor, Toronto, Ontario Canada M5S 1N5

Contact Name: EDSinfo@hqontario.ca

Contact Email: OH-HQO_hta-reg@ontariohealth.ca

Copyright: Health Quality Ontario