 previous article in this issue | next article in this issue  |
|
Document Details : Title: Long-term cost-benefit ratio of cardiac rehabilitation after percutaneous coronary intervention Author(s): P. Dendale , D. Hansen , J. Berger , M. Lamotte Journal: Acta Cardiologica Volume: 63 Issue: 4 Date: 2008 Pages: 451-456 DOI: 10.2143/AC.63.4.2033043 Abstract : Objective — Cardiac rehabilitation (CR) has been shown to reduce short-term mortality and morbidity after percutaneous coronary intervention (PCI). Nonetheless, the long-term effects of CR after PCI and its cost-benefit ratio are not well studied.This study analyses the effect of multidisciplinary, hospital-based, ambulatory CR on long-term health-related costs after PCI. Methods and results — 213 patients were studied after PCI: 133 patients referred to cardiac rehabilitation were compared with 80 patients who were referred for PCI from another hospital, where no rehabilitation was available. The hospital files of these patients were studied and the patient and/or his/her general practitioner were contacted by telephone after a follow-up of approximately 4.5 years. All cardiovascular events (recurrent angina, coronary revascularization, acute myocardial infarction, and death) were noted and their cost to the community was calculated. Compared to no CR, CR resulted in a significant reduction of hospitalizations for angina (75% vs. 45%), and coronary revascularizations (17% vs. 7%). There was a significant increase in the incidence of myocardial infarction (2.5% vs. 7.5%). The intervention group experienced a total of 0.93 events/patient, as compared to 1.52 events/patient in the control group. The total health care cost (including the cost of CR) at 4.5 years of follow-up was lower in the rehabilitation group compared to the control group (4,862 €/patient vs. 5,498 €/patient). Conclusion — Cardiac rehabilitation after PCI not only significantly reduces the number of cardiac events, but, despite the additional cost due to CR, results in cost savings from the Belgian health care payer’s perspective. |
