Program organization in pulmonary rehabilitation.

Variable aspects of pulmonary rehabilitation (PR) programs include staff composition, setting, structure, and duration. Longer PR programs generally translate into greater improvements in outcomes and (perhaps) prolonged maintenance of benefits. Barriers to PR include transportation issues, inconvenience for the patient, cost and insurance coverage problems, lack of perceived benefit, concurrent illness, and influence of the provider. PR settings include inpatient and outpatient environments. PR has been shown to improve health care utilization during or immediately following chronic obstructive pulmonary disease exacerbations. Challenges to providing PR may be partially addressed by technological developments.