Tri-State Regional Pulmonary Rehabilitation Survey. Program characteristics and practices

This report summarizes the pulmonary rehabilitation characteristics found in the 1991 survey of programs in the Pennsylvania, New Jersey, and Delaware region.

A listing of 111 potential Tri-state regional programs with pulmonary rehabilitation was compiled. A 34-item questionnaire was developed. Using multiple mailings and phone-call follow-up, 59 programs of 100 the active programs in the region returned the questionnaires. Programs that were providing services to patients with pulmonary disease were compared to those focusing on patients with cardiac and/or pulmonary disease.

A third of all programs (31%) used combined cardiopulmonary services. Pulmonary-only programs averaged 1.7 hours per day, and cardiopulmonary programs averaged 1.1 hours per day (P < .01). Both types of programs averaged 2.4 days per week. Average duration of pulmonary-only programs was 8.7 weeks, and duration of cardiopulmonary programs was 10.6 weeks (P < .05). Most programs (85%) required referral from the patients' primary physician. Many programs (64%) reported that local physicians other than the program's medical director referred a majority of the patients. Almost all programs (92%) performed exercise testing before initiating pulmonary rehabilitation. Post-rehabilitation discharge planning seemed to be based in many programs on performance measures taken during the final rehabilitation sessions or from a final 6- or 12-minute walk. Educational sessions were provided by 95% of the programs. Maintenance sessions were not offered by 39% of the programs. Seventy-three percent of the pulmonary-only programs and 44% of the cardiopulmonary programs offered support groups (P < .05). The pulmonary-only program coordinator's specialty was mostly respiratory therapy (70%), whereas in cardiopulmonary programs, coordinators tended to be nurses (39%) or from other nonrespiratory specialties (28%). No respiratory staff were used by 38% of the cardiopulmonary programs.

The type of rehabilitation program, either pulmonary-only or cardiopulmonary, appears to influence many program characteristics (e.g., hours per day, weeks in duration, coordinator's specialty, and staffing).