University of California San Francisco, San Francisco California.
Respir Care. 2023 Jul;68(7):983-997. doi: 10.4187/respcare.10520.
Pulmonary rehabilitation (PR) is a high-value intervention for persons with COPD and other chronic lung diseases. It is associated with improvement in exercise capacity, dyspnea, health-related quality of life, and depression as well as a reduction in hospitalization and improved survival when PR follows COPD-related hospitalizations. PR is underused in the United States and other countries despite strong evidence of both clinical effectiveness and cost-effectiveness. Additional challenges include a lack of equitable reimbursement and poor access, particularly in rural settings. Models, for example, virtual PR, may be an option for improving access but coverage in the United States by Medicare is tenuous. In addition, virtual PR models have considerable heterogeneity, which challenges uniform efficacy and selection of optimal candidates.
肺康复（PR）是一种针对 COPD 和其他慢性肺部疾病患者的高价值干预措施。它与运动能力、呼吸困难、健康相关生活质量和抑郁的改善有关，同时还可以降低住院率，改善生存情况，尤其是在 COPD 相关住院后进行 PR 的情况下。尽管 PR 在临床效果和成本效益方面都有强有力的证据，但在美国和其他国家的使用率仍然很低。其他挑战包括公平报销和服务可及性不足，尤其是在农村地区。例如，虚拟 PR 等模式可能是改善可及性的一种选择，但美国医疗保险对虚拟 PR 的覆盖范围还不稳定。此外，虚拟 PR 模式存在相当大的异质性，这对统一疗效和选择最佳候选者提出了挑战。
