title: Availability and characteristics of cardiovascular rehabilitation programs in South America.
abstract: OBJECTIVE
  Cardiac rehabilitation (CR) programs decrease morbidity and mortality rates in patients with coronary artery disease, the leading cause of death in Latin America. This study was carried out to assess the characteristics and current level of CR program implementation in South America.
  
  
  METHODS
  We carried out a survey of CR programs that were identified using the directory of the South American Society of Cardiology and through an exhaustive search by the investigators.
  
  
  RESULTS
  We identified 160 CR programs in 9 of the 10 countries represented in the South American Society of Cardiology and 116 of those responded to our survey. On the basis of survey results from the responding programs, we estimate that the availability of CR programs in South America is extremely low, approximately 1 CR program for every 2 319 312 inhabitants. These CR programs provided services to a median of 180 patients per year (interquartile range, 60-400) and were most commonly led by cardiologists (84%) and physical therapists (72%). Phases I, II, III, and IV CR were offered in 49%, 91%, 89%, and 56% of the centers, respectively. The most commonly perceived barrier to participation in a CR program was lack of referral from the cardiologist or primary care physician, as reported by 70% of the CR program directors.
  
  
  CONCLUSIONS
  The number of CR programs in South America appears to be insufficient for a population with a high and growing burden of cardiovascular disease. In addition, there appears to be a significant need for standardization of CR program components and services in the region.
authors.affiliation: Department of Internal Medicine, Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA.
authors.forename: Mery
authors.initials: M
authors.lastname: Cortes-Bergoderi
authors.forename: Francisco
authors.initials: F
authors.lastname: Lopez-Jimenez
authors.forename: Artur H
authors.initials: AH
authors.lastname: Herdy
authors.forename: Cecilia
authors.initials: C
authors.lastname: Zeballos
authors.forename: Claudia
authors.initials: C
authors.lastname: Anchique
authors.forename: Claudio
authors.initials: C
authors.lastname: Santibañez
authors.forename: Gerard
authors.initials: G
authors.lastname: Burdiat
authors.forename: Graciela
authors.initials: G
authors.lastname: Gonzalez
authors.forename: Karina
authors.initials: K
authors.lastname: Gonzalez
authors.forename: Bartolome
authors.initials: B
authors.lastname: Finizola
authors.forename: Rosalia
authors.initials: R
authors.lastname: Fernandez
authors.forename: Maria
authors.initials: M
authors.lastname: Paniagua
authors.forename: Randal J
authors.initials: RJ
authors.lastname: Thomas
authors.forename: Juan
authors.initials: J
authors.lastname: Gonzalez-Moreno
authors.forename: Juan Pablo
authors.initials: JP
authors.lastname: Rodriguez-Escudero
authors.forename: Carmen
authors.initials: C
authors.lastname: Perez-Terzic
mesh_terms: D000368:Aged; D000072038:Cardiac Rehabilitation; D002309:Cardiology / Q000458:organization & administration*; D002318:Cardiovascular Diseases / Q000453:epidemiology; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000592:standards*; D006301:Health Services Needs and Demand / Q000592:standards*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D016730:Program Development; D012047:Rehabilitation Centers / Q000706:statistics & numerical data*; D012955:Societies, Medical; D013020:South America / Q000453:epidemiology