Economic evaluation of cardiac rehabilitation and secondary prevention services

Abstract

Little is known about the relative cost-effectiveness (CE) of different cardiac rehabilitation (CR) program designs and how CE is influenced by a patient's clinical and demographic characteristics. The aim of this study was to assess the 2-year incremental cost-utility of a distributed (12-month, 33-session) CR program to that of a standard (3-month, 33-session) CR program as assessed from the perspective of the cardiac health care system. 306 Patients (mean age = 58.4 years, SD+/-9.7) with CAD were randomized to either standard or distributed CR. Program delivery costs, cardiac health care use, QALYS were tracked over a two-year period. The standard CR intervention was found to be dominant, resulting in both a cost saving and larger gains in QALYs in the 2-years following initiation of CR. Important differences were noted in CE of CR across cardiac risk strata and diagnosis groups, suggesting patients may benefit from triage to available CR models.