title: Economic evaluation of a randomised trial of early return to normal activities versus cardiac rehabilitation after acute myocardial infarction.
abstract: BACKGROUND
  Although there have been a number of economic evaluations of cardiac rehabilitation after acute myocardial infarction (AMI), none has considered only low-risk patients or control groups with no rehabilitation at all.
  
  
  METHODS
  An economic evaluation was included in a randomised controlled trial of patients following uncomplicated AMI. Eligible patients were randomised to return to normal activities after 6 weeks of standard rehabilitation (REHAB, n = 70) or to early return to normal activities 2 weeks after AMI with no formal rehabilitation (ERNA, n = 72). Outcomes were assessed weekly for 6 weeks, then 3, 6 and 12 months post-AMI. Outcomes included four quality of life (QOL) measures (physical abilities, distress, usual/social activities, self-care) and four measures of return to normal activities (paid and unpaid return to any work and to pre-AMI level of work). Statistical analysis included repeated-measures regression (QOL outcomes) and survival analysis (work outcomes).
  
  
  RESULTS
  There were no statistically significant differences between the two groups in any of the outcomes measured or in the use of other health services. The net cost that could be saved by the health service by targeting rehabilitation to high-risk patients was approximately $300 (Australian, 1999) per low-risk patient.
  
  
  CONCLUSIONS
  Early return to normal activities without formal rehabilitation is cost-effective for low-risk patients.
authors.affiliation: Centre for Health Economics Research and Evaluation (CHERE), Sydney, Australia. janeh@chere.usyd.edu.au
authors.forename: Jane P
authors.initials: JP
authors.lastname: Hall
authors.forename: Virginia L
authors.initials: VL
authors.lastname: Wiseman
authors.forename: Madeleine T
authors.initials: MT
authors.lastname: King
authors.forename: David L
authors.initials: DL
authors.lastname: Ross
authors.forename: Pramesh
authors.initials: P
authors.lastname: Kovoor
authors.forename: Robert P
authors.initials: RP
authors.lastname: Zecchin
authors.forename: Fiona M
authors.initials: FM
authors.lastname: Moir
authors.forename: A
authors.initials: A
authors.lastname: Robert Denniss