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https://doi.org/10.1186/1472-6963-12-243
Title: | A systematic review of economic evaluations of cardiac rehabilitation | Authors: | Wong, W.P Feng, J Pwee, K.H Lim, J |
Keywords: | adult bibliographic database comparative effectiveness cost benefit analysis cost of illness economics heart failure heart infarction home care human male patient care review Singapore Adult Comparative Effectiveness Research Cost of Illness Cost-Benefit Analysis Databases, Bibliographic Heart Failure Home Care Services Humans Male Myocardial Infarction Patient-Centered Care Singapore |
Issue Date: | 2012 | Citation: | Wong, W.P, Feng, J, Pwee, K.H, Lim, J (2012). A systematic review of economic evaluations of cardiac rehabilitation. BMC Health Services Research 12 (1) : 243. ScholarBank@NUS Repository. https://doi.org/10.1186/1472-6963-12-243 | Rights: | Attribution 4.0 International | Abstract: | Background: Cardiac rehabilitation (CR), a multidisciplinary program consisting of exercise, risk factor modification and psychosocial intervention, forms an integral part of managing patients after myocardial infarction (MI), revascularization surgery and percutaneous coronary interventions, as well as patients with heart failure (HF). This systematic review seeks to examine the cost-effectiveness of CR for patients with MI or HF and inform policy makers in Singapore on published cost-effectiveness studies on CR. Methods: Electronic databases (EMBASE, MEDLINE, NHS EED, PEDro, CINAHL) were searched from inception to May 2010 for published economic studies. Additional references were identified through searching bibliographies of included studies. Two independent reviewers selected eligible publications based on the inclusion/exclusion criteria. Quality assessment of economic evaluations was undertaken using Drummond's checklist. Results: A total of 22 articles were selected for review. However five articles were further excluded because they were cost-minimization analyses, whilst one included patients with stroke. Of the final 16 articles, one article addressed both centre-based cardiac rehabilitation versus no rehabilitation, as well as home-based cardiac rehabilitation versus no rehabilitation. Therefore, nine studies compared cost-effectiveness between centre-based supervised CR and no CR; three studies examined that between centre- and home based CR; one between inpatient and outpatient CR; and four between home-based CR and no CR. These studies were characterized by differences in the study perspectives, economic study designs and time frames, as well as variability in clinical data and assumptions made on costs. Overall, the studies suggested that: (1) supervised centre-based CR was highly cost-effective and the dominant strategy when compared to no CR; (2) home-based CR was no different from centre-based CR; (3) no difference existed between inpatient and outpatient CR; and (4) home-based programs were generally cost-saving compared to no CR. Conclusions: Overall, all the studies supported the implementation of CR for MI and HF. However, comparison across studies highlighted wide variability of CR program design and delivery. Policy makers need to exercise caution when generalizing these findings to the Singapore context. © 2012 Wong et al.; licensee BioMed Central Ltd. | Source Title: | BMC Health Services Research | URI: | https://scholarbank.nus.edu.sg/handle/10635/181603 | ISSN: | 14726963 | DOI: | 10.1186/1472-6963-12-243 | Rights: | Attribution 4.0 International |
Appears in Collections: | Staff Publications Elements |
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