Consequences for patients with severe COPD in the Netherlands visible due to reduction of longterm Physical Therapy rehabilitation
Exacerbations, use of medication and length of stay in hospital have increased after a six months reduction of frequency of longterm Physical Therapy rehabilitation patients with severe to very severe COPD.
On the advice of the governmental Nederlandse Zorginstituut, the frequency of longterm Physical Therapy rehabilitation is reduced (x2 to x1 per week) from the 1st of January 2019 as a austerity measure for patients with severe to very severe COPD (GOLD III and IV). The Physical Therapy & Science Association therefore initiated a longitudinal cohort study (two years) to monitor patients with severe to very severe COPD over time and to investigate the consequences of reducing the average frequency of twice a week to once a week physical therapy. A total of 304 patients were included for the study in close collaboration with 22 primary Physical Therapy practices in The Netherlands.
After six months of frequency reduction, it appears that differences already arise between the group that rehabilitates twice a week, compared to the group who is offered once a week physiotherapy rehabilitation. The differences manifest themselves in more exacerbations, medication use (antibiotics and prednisone) and length of stay in hospital (days LOS), if they are only offered rehabilitation once a week. Martin Keesenberg (physical therapist / clinical health scientist) emphasizes that this means a deterioration of the health status of the patient, but also a direct rise of healthcare costs due to the sharp increase of longer stay of patients in hospital. At the beginning of January 2020, the effects of the entire year 2019 will be analyzed with a reduced frequency of Physical Therapy. The results will be published both nationally and internationally. Physical Therapists and scientists are concerned about patients if the frequency of Physical Therapy will be reduced even more from the 1st of January 2020.