Pulmonary rehabilitation: a classic tune with a new beat, but is anyone listening?

Abstract:

:Comprehensive pulmonary rehabilitation and respiratory therapy services benefit patients with chronic lung disease and other diseases of the lung by reducing symptoms and restoring independent function. Although the science of these therapies is not new, commercial payers and Medicare have generally been slow to support adequate coverage and reimbursement. These therapies are described as a multidisciplinary approach to individual patient care through a physician-supervised program that usually includes physician-prescribed exercise, education and/or training, psychosocial assessment, and an outcomes assessment comprehensively documented using an individualized treatment plan. This article includes a review of the requirements based on the July 2008 Congressional enactment of a new national policy for comprehensive pulmonary rehabilitation program coverage. Passage of Section 144 of the Medicare Improvements for Patients and Providers Act authorizes comprehensive pulmonary rehabilitation programs to be a covered Medicare benefit. Variability of coverage by various payers will be examined. Also discussed are various coding schema for the provision and reporting of comprehensive pulmonary rehabilitation and respiratory therapy services. The variability of requirements to establish medical necessity among several major payers of respiratory therapy services and comprehensive pulmonary rehabilitation programs will be explored. Despite these therapies being recognized universally as the standard of care for certain diseases and a new national mandate establishing coverage regulations, the continuation, expansion, and patient access for such therapies may be limited. Pitfalls and pluses are discussed.

journal_name

Chest

journal_title

Chest

authors

Birnbaum S

doi

10.1378/chest.10-2392

subject

Has Abstract

pub_date

2011-06-01 00:00:00

pages

1498-1502

issue

6

eissn

0012-3692

issn

1931-3543

pii

S0012-3692(11)60311-5

journal_volume

139

pub_type

杂志文章,评审

相关文献

CHEST文献大全
  • The effects of cocaine and heroin use on intubation rates and hospital utilization in patients with acute asthma exacerbations.

    abstract:BACKGROUND:The use of both heroin and cocaine has been associated with asthma exacerbations. However, the magnitude of this effect has not been adequately described. The purpose of this study was to examine the association between cocaine or heroin use and asthma severity. METHODS:We conducted a retrospective chart re...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.128.4.1951

    authors: Levine M,Iliescu ME,Margellos-Anast H,Estarziau M,Ansell DA

    更新日期:2005-10-01 00:00:00

  • Effects of flecainide and propafenone on systolic performance in subjects with normal cardiac function.

    abstract::Flecainide and propafenone are effective in suppressing both ventricular and supraventricular tachyarrhythmias, but their efficacy is often limited by dose-related side effects. This study was performed to evaluate noninvasively the effects of intravenous flecainide and propafenone on left ventricular systolic functio...

    journal_title:Chest

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1378/chest.103.4.1068

    authors: Santinelli V,Arnese M,Oppo I,Matarazzi C,Maione S,Palma M,Giunta A

    更新日期:1993-04-01 00:00:00

  • A rare endobronchial neurilemmoma (Schwannoma).

    abstract::Primary neurogenic tumors of the lung are rare. Often, their histologic behavior presents a treatment dilemma. We present a case of benign endobronchial neurilemmoma managed by means of YAG laser resection together with a brief discussion of the management options available for these tumors. ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.95.2.461

    authors: Feldhaus RJ,Anene C,Bogard P

    更新日期:1989-02-01 00:00:00

  • Talc pleurodesis through indwelling pleural catheters for malignant pleural effusions: retrospective case series of a novel clinical pathway.

    abstract::Malignant pleural effusions cause significant morbidity, but there is no gold standard minimally invasive treatment. A new therapeutic approach combines talc pleurodesis and indwelling pleural catheters (IPCs) to enable outpatient management. This case series summarizes the safety and efficacy data of all patients (24...

    journal_title:Chest

    pub_type: 临床试验,杂志文章

    doi:10.1378/chest.14-0394

    authors: Ahmed L,Ip H,Rao D,Patel N,Noorzad F

    更新日期:2014-12-01 00:00:00

  • Intrathoracic chemothermotherapy following panpleuropneumonectomy for pleural dissemination of invasive thymoma.

    abstract::We report a case of pleural dissemination of invasive thymoma, which was successfully treated with intrathoracic chemothermotherapy following panpleuropneumonectomy. Intrathoracic chemothermotherapy in combination with surgery may be a hopeful adjuvant treatment to control pleural disseminated lesions of invasive thym...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.105.6.1884

    authors: Higashiyama M,Doi O,Kodama K,Yokouchi H

    更新日期:1994-06-01 00:00:00

  • Long-term physiologic outcome after acute farmer's lung.

    abstract::We performed a follow-up study of 61 patients who had an acute episode of farmer's lung (54 men and seven women). Twenty-four subjects had ceased all contact with the barn, while 37 had continued farming. Pulmonary function tests for all subjects showed an initial improvement after the acute episode: 92.4 +/- 36.9 per...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.87.6.796

    authors: Cormier Y,Bélanger J

    更新日期:1985-06-01 00:00:00

  • Sleep apnea syndrome. A critical review of the apnea index as a diagnostic criterion.

    abstract::The utility of the apnea index (number of apneic events per hour of sleep) in diagnosing sleep apnea syndrome is reviewed. Data from currently extant reports indicate that many otherwise normal, aging subjects may be classified as having sleep apnea syndrome based on the current diagnostic threshold of five apneic epi...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.86.4.529

    authors: Berry DT,Webb WB,Block AJ

    更新日期:1984-10-01 00:00:00

  • Genetics and pulmonary hypertension.

    abstract::Primary pulmonary hypertension (PPH) is a serious pulmonary vascular disease occurring mostly in adult women. Although its occurrence in families was reported within a few years after the original clinical report, PPH was formerly believed rarely to have a genetic basis. Recent progress has not only clarified a basic ...

    journal_title:Chest

    pub_type: 杂志文章,评审

    doi:10.1378/chest.122.6_suppl.284s

    authors: Loyd JE

    更新日期:2002-12-01 00:00:00

  • Efficacy of 67Ga-scintigraphy in predicting the diagnostic yield of transbronchial lung biopsy in pulmonary sarcoidosis.

    abstract::Nineteen consecutive patients with clinically suspected sarcoidosis underwent 67Ga-scintigraphy prior to transbronchial lung biopsy (TBLB) to determine if 67Ga uptake in lung parenchyma would increase the diagnostic yield of the biopsy procedure. Biopsies were obtained from the areas showing parenchymal uptake on the ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.82.1.7

    authors: Ackart RS,Munzel TL,Rodriguez JJ,Donlan CJ,Klayton RJ,Foreman DR

    更新日期:1982-07-01 00:00:00

  • Acute pulmonary effects of nitrogen dioxide exposure during exercise in competitive athletes.

    abstract::The acute pulmonary responses of athletes after short-term exposure to ambient concentrations of NO2 during heavy exercise have been examined. Intercollegiate male athletes were screened for history of cardiac disease, respiratory disease, allergic conditions and extensive exposure to pollutants. After completion of s...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.99.4.815

    authors: Kim SU,Koenig JQ,Pierson WE,Hanley QS

    更新日期:1991-04-01 00:00:00

  • Management of pediatric acute hypoxemic respiratory insufficiency with bilevel positive pressure (BiPAP) nasal mask ventilation.

    abstract:OBJECTIVES:To evaluate the efficacy and complications of noninvasive nasal mask bilevel continuous positive airway pressure ventilation in pediatric patients with hypoxemic respiratory insufficiency. DESIGN:Retrospective chart review. SETTING:Intensive care unit, university affiliated tertiary care children's hospita...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.108.4.1059

    authors: Fortenberry JD,Del Toro J,Jefferson LS,Evey L,Haase D

    更新日期:1995-10-01 00:00:00

  • Femoral venoarterial extracorporeal membrane oxygenation for severe reimplantation response after lung transplantation.

    abstract::Severe pulmonary reimplantation response after lung transplantation is not very common, although the mortality can be high. We present a patient who developed an extremely severe reperfusion injury after bilateral lung transplantation. Because of severe hypoxia and hemodynamic instability, despite aggressive ventilato...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.118.2.559

    authors: Vlasselaers D,Verleden GM,Meyns B,Van Raemdonck D,Demedts M,Lerut A,Lauwers P

    更新日期:2000-08-01 00:00:00

  • Chronic Bronchitis Is Associated With Worse Symptoms and Quality of Life Than Chronic Airflow Obstruction.

    abstract:BACKGROUND:COPD includes the chronic bronchitis (CB) and emphysema phenotypes. Although it is generally assumed that emphysema or chronic airflow obstruction (CAO) is associated with worse quality of life (QOL) than is CB, this assumption has not been tested. METHODS:The current study's analyses from the Lovelace Smok...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.14-2240

    authors: Meek PM,Petersen H,Washko GR,Diaz AA,Klm V,Sood A,Tesfaigzi Y

    更新日期:2015-08-01 00:00:00

  • Heimlich valve treatment of Pneumocystis carinii-associated pneumothorax.

    abstract::Two patients were treated for AIDS-associated bilateral pneumothoraces which persisted despite prolonged chest tube drainage. Heimlich flutter valves were used to facilitate the outpatient management of these patients. ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.100.1.281

    authors: Driver AG,Peden JG,Adams HG,Rumley RL

    更新日期:1991-07-01 00:00:00

  • Antimyosin scintigraphy for detection of myocarditis. Scintigraphic follow-up.

    abstract::To examine the value of antimyosin-indium 111 imaging in relation to endomyocardial biopsy in patients with suspected myocarditis, as well as the natural evolution of abnormal findings on the antimyosin scan, 12 patients with suspected myocarditis underwent endomyocardial biopsy and antimyosin scan. The heart-to-lung ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.104.5.1427

    authors: Lekakis J,Nanas J,Moustafellou A,Kostamis P,Moulopoulos S

    更新日期:1993-11-01 00:00:00

  • Saprophytic fungal infections and complications involving the bronchial anastomosis following human lung transplantation.

    abstract:STUDY OBJECTIVE:To demonstrate an association between saprophytic fungal infections occurring at the bronchial anastomosis (BA) and the development of additional complications arising at this site. DESIGN:Retrospective review. SETTING:University lung transplant center. MATERIALS AND METHODS:Review of all single-lung...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.122.4.1185

    authors: Nunley DR,Gal AA,Vega JD,Perlino C,Smith P,Lawrence EC

    更新日期:2002-10-01 00:00:00

  • Skin sensitivity to histolyn, spherulin, and PPD in the People's Republic of China.

    abstract::One hundred one subjects living in northwest Hunan Province, People's Republic of China (PRC) were tested with histolyn, (Berkeley Biological Laboratories), spherulin (Berkeley Biological Laboratories), and tubersol (PPD 5 tuberculin units, Connaught Laboratories). Age of the tested subjects ranged from 16 to 58 years...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.97.6.1356

    authors: Baum GL,Wu JN,Hua SS,Baum C,Ajello L

    更新日期:1990-06-01 00:00:00

  • Inhalation challenge with sulfidopeptide leukotrienes in human subjects.

    abstract::What is the meaning of these findings to the practicing chest physician? First, leukotrienes are potent airway constrictors; they are capable of reproducing the type of airway constriction observed in asthma. The role of leukotrienes in this regard has yet to be established, but experiments to test the importance of t...

    journal_title:Chest

    pub_type: 杂志文章,评审

    doi:10.1378/chest.89.3.414

    authors: Drazen JM

    更新日期:1986-03-01 00:00:00

  • Varying ejection fractions of both ventricles in paradoxical pulses: demonstration by radionuclide study.

    abstract::A noninvasive radionuclide study of the paradoxical pulse in pericardial effusion is described. The study shows complementary changes of the right and left ventricular ejection fractions in a patient with paradoxical pulse, supporting the theory that the inspiratory reduction of the left ventricular stroke volume is a...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.74.6.687

    authors: Yeh EL

    更新日期:1978-12-01 00:00:00

  • Left atrial function as a reliable predictor of exercise capacity in patients with recent myocardial infarction.

    abstract:STUDY OBJECTIVE:To examine the relation between left atrial (LA) function and exercise performance. DESIGN AND SETTING:Retrospective study at a referral cardiopulmonary exercise laboratory in a university hospital. PATIENTS:Forty-one patients with recent myocardial infarction. INTERVENTIONS:M-mode echocardiography a...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.111.4.922

    authors: Jikuhara T,Sumimoto T,Tarumi N,Yuasa F,Hattori T,Sugiura T,Iwasaka T

    更新日期:1997-04-01 00:00:00

  • Modafinil as adjunct therapy for daytime sleepiness in obstructive sleep apnea: a 12-week, open-label study.

    abstract:STUDY OBJECTIVES:The purpose of this 12-week study was to evaluate the efficacy and safety of adjunct modafinil to treat excessive sleepiness in patients with obstructive sleep apnea (OSA) who experience residual sleepiness despite regular nasal continuous positive airway pressure (nCPAP) use. DESIGN:Twelve-week, open...

    journal_title:Chest

    pub_type: 临床试验,杂志文章,多中心研究

    doi:10.1378/chest.124.6.2192

    authors: Schwartz JR,Hirshkowitz M,Erman MK,Schmidt-Nowara W

    更新日期:2003-12-01 00:00:00

  • Activation of sympathetic tone during dipyridamole test.

    abstract::Cardiac imaging with dipyridamole infusion has been proposed as an exercise-independent tool for the diagnosis of coronary artery disease. Dipyridamole acts through the accumulation of adenosine, which reduces sympathetic tone in vasomotor nuclei of the brainstem and inhibits norepinephrine release in noradrenergic ne...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.102.2.444

    authors: Lucarini AR,Picano E,Marini C,Favilla S,Salvetti A,Distante A

    更新日期:1992-08-01 00:00:00

  • Reactive airway dysfunction syndrome in three police officers following a roadside chemical spill.

    abstract::The reactive airway dysfunction syndrome (RADS) is a recently described syndrome in which bronchial hyperreactivity and asthmatic symptoms develop in previously healthy individuals after a single large exposure to an irritating gas, fume, or vapor. We report a cluster of three Philadelphia police officers who develope...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.98.4.928

    authors: Promisloff RA,Lenchner GS,Phan A,Cichelli AV

    更新日期:1990-10-01 00:00:00

  • Antitrypsin and chronic obstructive pulmonary disease among Japanese-American men.

    abstract::A total of 161 patients with chronic obstructive pulmonary disease (COPD) plus 100 control subjects (identified during a study of heart disease in 6,860 Japanese-American men aged 52 to 75 years who were residing in Hawaii) were analyzed for phenotype in search of the antitrypsin gene Z, which has been shown to be ass...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.72.4.489

    authors: Roberts A,Kagan A,Rhoads GG,Pierce JA,Bruce RM

    更新日期:1977-10-01 00:00:00

  • Human neutrophil collagenase (MMP-8), identified in bronchiectasis BAL fluid, correlates with severity of disease.

    abstract::Collagenases in bronchoalveolar lavage fluid (BALF) of patients with bronchiectasis and healthy subjects were characterized using specific functional and immunologic assays. The BAL fluid contained interstitial collagenase and collagenolytic proteinases of bacterial origin. Collagenase activities, obtained after organ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.107.6.1641

    authors: Sepper R,Konttinen YT,Ding Y,Takagi M,Sorsa T

    更新日期:1995-06-01 00:00:00

  • Survey of asthma practice among emergency physicians.

    abstract:PURPOSE:The National Asthma Education and Prevention Program (NAEPP) published guidelines for asthma management in 1991. The purpose of this study is to assess the concordance between emergency physicians' practice and the guidelines. DESIGN:Survey mailed to emergency physicians. Non-respondents were mailed a second c...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.109.3.708

    authors: Emerman CL,Cydulka RK,Skobeloff E

    更新日期:1996-03-01 00:00:00

  • Diagnosis of pneumothorax by ultrasound immediately after ultrasonically guided aspiration biopsy.

    abstract::We report two cases of pneumothorax detected by echographic examination immediately after ultrasonically guided aspiration biopsy and confirmed by chest x-ray film. The pneumothorax was characterized by the disappearance of the lung tumor. In the real-time image, the respiratory excursions of the visceral pleura also ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.101.3.855

    authors: Targhetta R,Bourgeois JM,Chavagneux R,Balmes P

    更新日期:1992-03-01 00:00:00

  • Bad medicine: low-dose dopamine in the ICU.

    abstract::Low-dose dopamine administration (ie, doses < 5 microg/kg/min) has been advocated for 30 years as therapy in oliguric patients on the basis of its action on dopaminergic renal receptors. Recently, a large, multicenter, randomized, controlled trial has demonstrated that low-dose dopamine administered to critically ill ...

    journal_title:Chest

    pub_type: 杂志文章,meta分析

    doi:10.1378/chest.123.4.1266

    authors: Holmes CL,Walley KR

    更新日期:2003-04-01 00:00:00

  • Sensitivity and Safety of Electromagnetic Navigation Bronchoscopy for Lung Cancer Diagnosis: Systematic Review and Meta-analysis.

    abstract:BACKGROUND:Bronchoscopy is a useful tool for the diagnosis of lesions near central airways; however, the diagnostic accuracy of these procedures for peripheral pulmonary lesions (PPLs) is a matter of ongoing debate. In this setting, electromagnetic navigation bronchoscopy (ENB) is a technique used to navigate and obtai...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1016/j.chest.2020.05.534

    authors: Folch EE,Labarca G,Ospina-Delgado D,Kheir F,Majid A,Khandhar SJ,Mehta HJ,Jantz MA,Fernandez-Bussy S

    更新日期:2020-10-01 00:00:00

  • Melioidosis complicated by pericarditis.

    abstract::A case of acute and recrudescent melioidosis complicated by pericarditis and pericardial effusion is described. The potential for the appearance of future cases in the United States and the necessity for physicians to remain aware of this potential diagnosis are discussed. ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.69.2.227

    authors: Ruff MJ,Lamkin N Jr,Braun J,Barnwell P

    更新日期:1976-02-01 00:00:00