Long-term cost-benefit ratio of cardiac rehabilitation after percutaneous coronary intervention.
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.


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 Euro/patient vs. 5,498 Euro/patient).


CONCLUSIONS
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.
Dendale
Paul
P
Rehabilitation and Health Centre, Virga Jesse Hospital, Stadsomvaart 11, 3500 Hasselt, Belgium. paul.dendale@virgajesse.be
Hansen
Dominique
D
Berger
Jan
J
Lamotte
Mark
M
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000191:economics* / Q000401:mortality; D001530:Belgium; D003324:Coronary Artery Disease / Q000191:economics* / Q000517:prevention & control / Q000534:rehabilitation*; D003362:Cost-Benefit Analysis; D005260:Female; D017048:Health Care Costs; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016730:Program Development / Q000191:economics; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D013997:Time Factors