ECONOMIC EFFICIENCY AND ORGANIZATIONAL ASPECTS OF IMPLEMENTATION OF CARDIAC REHABILITATION PROGRAMS ACCORDING TO INTERNATIONAL EXPERIENCE, PROSPECTS OF DEVELOPMENT IN UKRAINE
DOI:
https://doi.org/10.11603/1811-2471.2018.v0.i4.9599Keywords:
cardiac rehabilitation, cardiovascular rehabilitation, effectiveness, models, low/middle-income countriesAbstract
Cardiovascular diseases (CVD) continue to occupy the first place among the causes of mortality of the working-age population, and their prevalence is higher in low- and middle-income countries. Due to the limited financial resources of these countries, there is a need for rational allocation of funds allocated for health care. Preventive cardiology and cardiac rehabilitation (CR) acquire of particular importance in these conditions.
The aim – to review the scientific literature on the economic efficiency and organizational aspects of the implementation of the CR programs in countries with different income levels, to propose a model for Ukraine.
Material and Methods. The review of the literature on a selected topic in the MEDLINE database and on official electronic resources of international associations of cardiologists, physicians of physical and rehabilitation medicine was conducted. The search was conducted by keywords: cardiac rehabilitation, cardiorehabilitation, cardiovascular rehabilitation, low/middle income country, core components, models, benefit, effectiveness, economic effectiveness.
Results and Conclusion. The article analyzes the effectiveness and describes the features of the organization of the CR in countries with different income levels. Based on the review of the literature, conclusions were drawn on possible ways of development and a model of the organization of the CR in Ukraine was proposed. The use of alternative CR models can increase its accessibility for the majority of the population of Ukraine, improve the quality of life and reduce the mortality from CVD.
References
Kovalenko, V.M., & Dorohoi, A.P. (2016). Sertsevo-sudynni khvoroby: medychno-sotsialne znachennia ta stratehiia rozvytku kardiolohii v Ukraini [Cardiovascular diseases: medical and social significance and strategy of cardiology development in Ukraine]. [in Ukrainian].
Al Quait, A.I.M., & Doherty, P.J. (2017). Overview of Cardiac Rehabilitation Evidence, Benefits and Utilisation. Global Journal of Health Science, 38-48.
Wenger, N. (2007). Cardiac rehabilitation. Cardiovasc. Prev. and Rehab., 34, 1-11.
Lavie, C.J., & Milani, R.V. (2006). Adverse psychological and coronary risk profiles in young patients with coronary artery disease and benefits of formal cardiac rehabilitation. Archives of Internal Medicine, 166 (17), 1878-1883.
Clark, A.M., Hartling, L., Vandermeer, B., & McAlister, F.A. (2005). Meta-analysis: secondary prevention programs for patients with coronary artery disease. Annals of Internal Medicine, 143 (9), 659-672.
Willmer, K.A., & Waite, M. (2009). Clinical papers-Long-term benefits of cardiac rehabilitation: A five-year follow-up of community-based phase 4 programmes. British Journal of Cardiology, 16 (2), 73.
Shields, G.E., Wells, A., Doherty, P., Heagerty, A., Buck, D., & Davies, L. M. (2018). Cost-effectiveness of cardiac rehabilitation: a systematic review. Heart.
Taylor, R.S., Brown, A., Ebrahim, S., Jolliffe, J., Noorani, H., Rees, K., & Oldridge, N. (2004). Exercise-based rehabilitation for patients with coronary heart disease: systematic review and meta-analysis of randomized controlled trials. The American Journal of Medicine, 116 (10), 682-692.
Pesah, E., Supervia, M., Turk-Adawi, K., & Grace, S.L. (2017). A review of cardiac rehabilitation delivery around the world. Progress in Cardiovascular Diseases.
Piepoli, M.F., Corrà, U., Dendale, P., Frederix, I., Prescott, E., Schmid, J. P., ... & Graham, I. (2016). Challenges in secondary prevention after acute myocardial infarction: A call for action. European Journal of Preventive Cardiology, 23 (18), 1994-2006.
Lear, S.A., & Ignaszewski, A. (2001). Cardiac rehabilitation: a comprehensive review. Trials, 2 (5), 221.
Williams, M.A., Ades, P.A., Hamm, L.F., Keteyian, S.J., LaFontaine, T.P., Roitman, J.L., & Squires, R.W. (2006). Clinical evidence for a health benefit from cardiac rehabilitation: an update. American Heart Journal, 152 (5), 835-841.
Bittner, V., & Foody, J.A.M. (2007). Core components of cardiac rehabilitation/secondary prevention programs: 2007 Update. Journal of Cardiopulmonary Rehabilitation and Prevention, 27 (121/129).
Woodruffe, S., Neubeck, L., Clark, R. A., Gray, K., Ferry, C., Finan, J., ... & Briffa, T. G. (2015). Australian Cardiovascular Health and Rehabilitation Association (ACRA) core components of cardiovascular disease secondary prevention and cardiac rehabilitation 2014. Heart, Lung and Circulation, 24 (5), 430-441.
Sandesara, P.B., Lambert, C.T., Gordon, N.F., Fletcher, G.F., Franklin, B. A., Wenger, N.K., & Sperling, L. (2015). Cardiac rehabilitation and risk reduction: time to “rebrand and reinvigorate”. Journal of the American College of Cardiology, 65 (4), 389-395.
Juocevicius, A., Oral, A., Lukmann, A., Takáč, P., Tederko, P., Hāznere, I., ... & Christodoulou, N. (2018). Evidence-based position paper on Physical and Rehabilitation Medicine (PRM) professional practice for people with cardiovascular conditions. The European PRM position (UEMS PRM Section). European Journal of Physical and Rehabilitation Medicine, 54 (4), 634-643.
Piepoli, M.F., Corra, U., Adamopoulos, S., Benzer, W., Bjarnason-Wehrens, B., Cupples, M., ... & McGee, H. (2014). Secondary prevention in the clinical management of patients with cardiovascular diseases. Core components, standards and outcome measures for referral and delivery: a policy statement from the cardiac rehabilitation section of the European Association for Cardiovascular Prevention & Rehabilitation. Endorsed by the Committee for Practice Guidelines of the European Society of Cardiology. European Journal of Preventive Cardiology, 21 (6), 664-681.
Grace, S.L., Turk-Adawi, K.I., Contractor, A., Atrey, A., Campbell, N.R., Derman, W., ... & Buckley, J. (2016). Cardiac rehabilitation delivery model for low-resource settings: an international council of cardiovascular prevention and rehabilitation consensus statement. Progress in Cardiovascular Diseases, 59 (3), 303-322.
Centers for Medicare & Medicaid Services. (2014). Decision memo for cardiac rehabilitation (CR) programs–chronic heart failure (CAG-00437N). Medicare Coverage Database. Baltimore, MD: CMS.
Balady, G.J. (2007). American Heart Association Exercise, Cardiac Rehabilitation, and Prevention Committee, the Council on Clinical Cardiology; American Heart Association Council on Cardiovascular Nursing; American Heart Association Council on Epidemiology and Prevention; American Heart Association Council on Nutrition, Physical Activity, and Metabolism; American Association of Cardiovascular and Pulmonary Rehabilitation. Core components of cardiac rehabilitation/secondary prevention programs: 2007 update: a scientific .... Circulation, 115, 2675-2682.
ESC Prevention of CVD Programme: Rehabilitation. (2018). Retrieved from https://www.escardio.org/Education/ESC-Prevention-of-CVD-Programme/Rehabilitation.
Ades, P.A., Keteyian, S.J., Wright, J.S., Hamm, L.F., Lui, K., Newlin, K., ... & Thomas, R.J. (2017). Increasing cardiac rehabilitation participation from 20 % to 70 %: a road map from the Million Hearts Cardiac Rehabilitation Collaborative. In Mayo Clinic Proceedings, 92 (2), 234-242. Elsevier.
Malinovskaya, I.E., Shumakov, V.A., & Tereshchenko, N.M. (2016). Rannyaya postgospitalnaya kardioreabilitatsiya patsiyentov posle infarkta miokarda – osnova effektivnoy vtorichnoy profilaktiki [Early post-hospital cardiorehabilitation of patients after myocardial infarction is the basis of effective secondary prevention]. [in Russian].
Kaiser, M., Varvel, M., & Doherty, P. (2013). Making the case for cardiac rehabilitation: modelling potential impact on readmissions. NHS Improvement, London.
De Gruyter, E., Ford, G., & Stavreski, B. (2016). Economic and social impact of increasing uptake of cardiac rehabilitation services–a cost benefit analysis. Heart, Lung and Circulation, 25 (2), 175-183.
Mufunda, J., Nyarango, P., Kosia, A., Obgamariam, A., Mebrahtu, G., Usman, A., ... & Tesfay, A. (2005). Noncommunicable diseases in Africa: a silent hypertension epidemic in Eritrea. Journal of Human Hypertension, 19 (3), 255.
World Health Organization. (2005). Part three – what works: the evidence for action. Preventing chronic diseases: a vital investment. WHO Global Report.
Babu, A. S., Lopez-Jimenez, F., Thomas, R. J., Isaranuwatchai, W., Herdy, A.H., Hoch, J.S., & Grace, S.L. (2016). Advocacy for outpatient cardiac rehabilitation globally. BMC Health Services Research, 16 (1), 471.
(2018). Fond sotsialnoho strakhuvannia Ukrainy [Social Insurance Fund of Ukraine]. Retrieved from: http://www.fse.gov.ua/fse/control/main/uk/publish/article/954736.
(2018). Fond sotsialnoho strakhuvannia Ukrainy [Social Insurance Fund of Ukraine]. Retrieved from: http://www.fssu.gov.ua/fse/control/kievobl/uk/publish/article/92793;jsessionid=430E4043EAC9CC889FCB73708E712C38.
(2018). Fond sotsialnoho strakhuvannia Ukrainy [Social Insurance Fund of Ukraine]. Retrieved from: http://www.fssu.gov.ua/fse/control/main/uk/publish/article/952253.
(2018). Kabinet Ministriv Ukrainy – Uriad povnistiu zabezpechuie finansuvannia sanatorno-kurortnoho likuvannia dlia pilhovykh katehorii hromadian [The Cabinet of Ministers of Ukraine. The government fully provides funding for sanatorium treatment for privileged citizens]. Retrieved from: https://www.kmu.gov.ua/ua/news/uryad-povnistyu-zabezpechuye-finansuvannya-sanatorno-kurortnogo-likuvannya-dlya-pilgovih-kategorij-gromadyan.
(2018). Kardiotsentry [Cardiocenters]. Retrieved from: http://moz.gov.ua/kardiocentri.
