Implantación y características de los programas de rehabilitación cardíaca en el Sistema Nacional de Salud español

Márquez-Calderón, Soledad; Villegas, R.; Blanca, Eduardo Briones Pérez de la; González-Nieto, Víctor Sarmiento; Sánchez, Margarita Reina; Hidalgo, Ignacio Sáinz; Rami, José A Velasco; Soriano, Francisco Ridocci

doi:10.1157/13050331

Cited by 14 publications

(4 citation statements)

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“…Few departments could refer patients to phase III services despite realizing the importance of maintaining lifestyle changes and pharmaceutical interventions. Differences in healthcare systems, the organization of cardiac care worldwide, and time period for studying CR services do not permit direct comparison between the extent of CR in different countries; however, similar findings on overall poor CR coverage were reported from many countries during the 1990s [17][18][19][20][21].…”

Section: Discussionmentioning

confidence: 99%

Cardiac rehabilitation services in Denmark: Still room for expansion

Zwisler

Træden

Videbæk

et al. 2005

Scand J Public Health

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Section: Discussionmentioning

confidence: 99%

Cardiac rehabilitation services in Denmark: Still room for expansion

Zwisler

Træden

Videbæk

et al. 2005

Scand J Public Health

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“…Most programs are under-resourced to deliver comprehensive evidence-based services. Indeed, surveys of CR programs in Australia and New Zealand [13], China [14], Japan [15], Scotland [16], Spain [17], Latin America and the Caribbean [18][19][20], the Arab Region as well as Canada [21] substantiate this.…”

Section: Introductionmentioning

confidence: 93%

Funding sources and costs to deliver cardiac rehabilitation around the globe: Drivers and barriers

Moghei

Pesah

Turk-Adawi

et al. 2019

International Journal of Cardiology

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Background:Cardiac rehabilitation (CR) reach is minimal globally, primarily due to financial factors. This study characterized CR funding sources, cost to patients to participate, cost to programs to serve patients, and the drivers of these costs. Methods:In this cross-sectional study, an online survey was administered to CR programs globally.Cardiac associations and local champions facilitated program identification. Costs in each country were reported using purchasing power parity (PPP). Results were compared by World Bank country income classification using generalized linear mixed models. Results:111/203 (54.68%) countries in the world offer CR, of which data were collected in 93 (83.78% country response rate; N=1082 surveys, 32.0% program response rate). CR was most-often publicly funded (more in high-income countries [HICs]; p<.001), but in 60.20% of countries patients paid some or all of the cost. Funding source impacted capacity (p=.004), number of patients per exercise session (p<.001), personnel (p=.037), and functional capacity testing (p=.039). The median cost to serve 1 patient was $945.91PPP globally. In low and middleincome countries (LMICs), exercise equipment and stress testing were perceived as the most expensive delivery elements, with front-line personnel costs perceived as costlier in HICs (p=.003). Modifiable factors associated with higher costs included CR team composition (p=.001), stress testing (p=.002) and telemetry monitoring in HICs (p=.01), and not offering alternative models in LMICs (p=.02). Conclusions:Too many patients are paying out-of-pocket for CR, and more public funding is needed. Lowercost delivery approaches are imperative, and include walk tests, task-shifting, and intensity monitoring via perceived exertion.

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“…The number of CRPs continues to be low and they are poorly distributed in certain regions. 5 In 2003, only 12 public centers with CRPs were identified throughout the country. In recent years, some regions, such as ours, have endeavored to create new units to improve access for the population but in other regions there are still no CRPs in the public health care setting.…”

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confidence: 99%