title: New East-Westfalian Postoperative Therapy Concept: a telemedicine guide for the study of ambulatory rehabilitation of patients after cardiac surgery.
abstract: In-hospital rehabilitation can improve recovery of patients after surgery, but also contributes to the high costs of the German health system. A telemedicine-based rehabilitation used in the home as an alternative to in-hospital rehabilitation was evaluated in a pilot study. In an open trial, 170 patients performed a 3-month ambulatory rehabilitation after cardiac surgery. There were two groups (group 1 [n = 70] and group 2 [n = 100]). Group 1 participated in conventional in-hospital rehabilitation. Group 2 received ambulant rehabilitation using telemedicine. Physical performance, quality of life, (measured with a questionnaire), complications and costs were assessed and compared between the two groups. Maximal physical performance (MPP) was assessed at 6 and at 12 months after cardiac surgery. It was significantly increased by 46-54 watts in both study groups compared to their baseline value. Moreover, physical and psychological quality of life had increased in both study groups compared to baseline values. However, group 2 was the only group to show statistical significance in all categories. Fewer incidents of angina pectoris were reported within the study interval in group 2 compared to group 1 (p < 0.01). The total cost of rehabilitation was 58% lower in group 2 compared to group 1. Ambulatory rehabilitation using telemedicine improves physical performance, quality of life, is safe, and is inexpensive. Our data indicate that home-based rehabilitation is more effective than in-hospital rehabilitation for patients after cardiac surgery.
authors.affiliation: Klinik für Thorax- und Kardiovaskularchirurgie, Herzzentrum Nordrhein-Westfalen, Georgstrasse 11, 32545 Bad Oeynhausen, Germany. hkoertke@hdz-nrw.de
authors.forename: Heinrich
authors.initials: H
authors.lastname: Körtke
authors.forename: Hans
authors.initials: H
authors.lastname: Stromeyer
authors.forename: Armin
authors.initials: A
authors.lastname: Zittermann
authors.forename: Norbert
authors.initials: N
authors.lastname: Buhr
authors.forename: Elke
authors.initials: E
authors.lastname: Zimmermann
authors.forename: Elmar
authors.initials: E
authors.lastname: Wienecke
authors.forename: Reiner
authors.initials: R
authors.lastname: Körfer
mesh_terms: D000553:Ambulatory Care / Q000191:economics / Q000379:methods*; D006348:Cardiac Surgical Procedures / Q000534:rehabilitation*; D005260:Female; D005858:Germany; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D020127:Recovery of Function; D017216:Telemedicine; D016896:Treatment Outcome