Résumé
COPD is now considered by the WHO as the 3rd leading cause of death worldwide. The heavy burden it places on our healthcare systems will continue to grow. Pulmonary rehabilitation (PR), a well-established therapy for COPD patients, sees its benefits fade over time after patients return home. Current research questions focus on maintaining these benefits over the long term: this is referred to as PR maintenance (PRM). While PRM interventions already seem to demonstrate their effectiveness on various clinical outcomes, the question of their economic impact (direct and indirect costs) remains unanswered. Objective: to evaluate the impact of participation in the PRM program of the Occitan’Air network on the utilization of healthcare resources among COPD patients in the Occitania region. Methods: a retrospective cohort study, based on a French cohort conducted from 2011 to 2018, was carried out. The two groups of COPD patients either participated in standard in-patient PR programs or the Occitan’Air PRM program. The primary objective of the study was to compare the number of all-cause hospitalization days per year of follow-up between these two groups. Secondary objectives included comparing the different types of hospitalization, the number of consultations at the Montpellier University Hospital Center (UHC), different healthcare costs, and 5-year survival between the two groups. Results: 175 patients were included in the study: 93 in the PRM group and 82 in the PR group. Patients in the PRM group had an average of 1.31 hospitalization days per year (1.31 ± 0.34) versus 1.84 (1.84 ± 0.62) in the PR group, with no significant difference (p=0.48). A reduction in daily hospitalization costs at the UHC of 346 euros was observed (p=0.032), or 1,089 euros per year per patient (p=0.27). Over the 5-year follow-up period, survival was significantly higher in the PRM group (p=0.044). Conclusion: this study showed that participation in the Occitan’Air PRM program tends to reduce the burden placed by COPD patients on healthcare systems. It also reduces healthcare costs and improves patient survival. Organizing a maintenance program in the form of a patient association seems to be a relevant choice. Larger studies including more patients and with fewer missing data could better highlight the positive impact of this type of program on the utilization of healthcare systems.