Pulmonary Rehabilitation Programs Are Underused By Black Patients

A new study has found that black patients with chronic obstructive pulmonary disease (COPD) are less likely to use pulmonary rehabilitation programs than white patients, regardless of proximity to their home.

These new findings were presented at the American Thoracic Society’s 2019 International Conference by lead researcher Kerry Spitzer, PhD, MPA, from the Institute for Healthcare Delivery and Population Science at the University of Massachusetts Medical School–Baystate, on Tuesday, May 21.

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Dr Spitzer and colleagues came to this conclusion after analyzing data from the Centers for Medicare and Medicaid Services. Participants included in this analysis were Medicare beneficiaries aged 66 years or older who had been hospitalized for COPD during 2012.

Hospital-Referral Region (HRR) was used as the geographic unit of analysis.

“While the overall rates of [pulmonary rehabilitation] are low across the US, rates vary widely between HRRs, ranging from 0.52% to 7.1%, with an average expected rate of [pulmonary rehabilitation] receipt within 6 months of index COPD hospitalization of 2.2%,” the researchers wrote.

They also found that the range of expected rates was much lower for African Americans (0.0%-2.0%) than for whites (0.6%-7.3%).

The density of pulmonary rehabilitation programs per 1000 Medicare beneficiaries was the strongest predictor of HRR-level rate of pulmonary rehabilitation receipt.

“While [pulmonary rehabilitation] program density was a strong predictor of overall rates of [pulmonary rehabilitation] at the HRR level, rates of [pulmonary rehabilitation] receipt for black beneficiaries remain low regardless of program density,” the researchers concluded. “More research is needed to develop strategies to increase receipt of PR for all populations, but especially for black patients.”

—Amanda Balbi

Reference:

Spitzer KA, Stefan MS, Priya A, et al. Geographic and racial disparities in receipt of pulmonary rehabilitation following hospital discharge for COPD exacerbations. Paper presented at: ATS International Conference; May 17-22, 2019; Dallas, TX. https://www.abstractsonline.com/pp8/#!/5789/presentation/25836.