Cardiac Rehabilitation Availability and Density Around the Globe
Autor(a) principal: | |
---|---|
Data de Publicação: | 2019 |
Outros Autores: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10400.17/3431 |
Resumo: | Background: Despite the epidemic of cardiovascular disease and the benefits of cardiac rehabilitation (CR), availability is known to be insufficient, although this is not quantified. This study ascertained CR availability, volumes and its drivers, and density. Methods: A survey was administered to CR programs globally. Cardiac associations and local champions facilitated program identification. Factors associated with volumes were assessed using generalized linear mixed models, and compared by World Health Organization region. Density (i.e. annual ischemic heart disease [IHD] incidence estimate from Global Burden of Disease study divided by national CR capacity) was computed. Findings: CR was available in 111/203 (54.7%) countries; data were collected in 93 (83.8% country response; N = 1082 surveys, 32.1% program response rate). Availability by region ranged from 80.7% of countries in Europe, to 17.0% in Africa (p < .001). There were 5753 programs globally that could serve 1,655,083 patients/year, despite an estimated 20,279,651 incident IHD cases globally/year. Volume was significantly greater where patients were systematically referred (odds ratio [OR] = 1.36, 95% confidence interval [CI] = 1.35-1.38) and programs offered alternative models (OR = 1.05, 95%CI = 1.04-1.06), and significantly lower with private (OR = .92, 95%CI = .91-.93) or public (OR = .83, 95%CI = .82-84) funding compared to hybrid sources.Median capacity (i.e., number of patients a program could serve annually) was 246/program (Q25-Q75 = 150-390). The absolute density was one CR spot per 11 IHD cases in countries with CR, and 12 globally. Interpretation: CR is available in only half of countries globally. Where offered, capacity is grossly insufficient, such that most patients will not derive the benefits associated with participation. |
id |
RCAP_e324a3e6b5d9dd55ec8ec25d40cca112 |
---|---|
oai_identifier_str |
oai:repositorio.chlc.min-saude.pt:10400.17/3431 |
network_acronym_str |
RCAP |
network_name_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository_id_str |
7160 |
spelling |
Cardiac Rehabilitation Availability and Density Around the GlobeHSM CARCardiac rehabilitationCapacityDensityGlobal HealthHealth ServicesPreventive CardiologyBackground: Despite the epidemic of cardiovascular disease and the benefits of cardiac rehabilitation (CR), availability is known to be insufficient, although this is not quantified. This study ascertained CR availability, volumes and its drivers, and density. Methods: A survey was administered to CR programs globally. Cardiac associations and local champions facilitated program identification. Factors associated with volumes were assessed using generalized linear mixed models, and compared by World Health Organization region. Density (i.e. annual ischemic heart disease [IHD] incidence estimate from Global Burden of Disease study divided by national CR capacity) was computed. Findings: CR was available in 111/203 (54.7%) countries; data were collected in 93 (83.8% country response; N = 1082 surveys, 32.1% program response rate). Availability by region ranged from 80.7% of countries in Europe, to 17.0% in Africa (p < .001). There were 5753 programs globally that could serve 1,655,083 patients/year, despite an estimated 20,279,651 incident IHD cases globally/year. Volume was significantly greater where patients were systematically referred (odds ratio [OR] = 1.36, 95% confidence interval [CI] = 1.35-1.38) and programs offered alternative models (OR = 1.05, 95%CI = 1.04-1.06), and significantly lower with private (OR = .92, 95%CI = .91-.93) or public (OR = .83, 95%CI = .82-84) funding compared to hybrid sources.Median capacity (i.e., number of patients a program could serve annually) was 246/program (Q25-Q75 = 150-390). The absolute density was one CR spot per 11 IHD cases in countries with CR, and 12 globally. Interpretation: CR is available in only half of countries globally. Where offered, capacity is grossly insufficient, such that most patients will not derive the benefits associated with participation.ElsevierRepositório do Centro Hospitalar Universitário de Lisboa Central, EPETurk-Adawi, KSupervia, MLopez-Jimenez, FPesah, EDing, RBritto, RRBjarnason-Wehrens, BDerman, WAbreu, ABabu, ASSantos, CAJong, SKCuenza, LYeo, TJScantlebury, DAndersen, KGonzalez, GGiga, VVulic, DuVataman, ECliff, JKouidi, EYagci, IKim, CBenaim, BEstany, ERFernandez, RRadi, BGaita, DSimon, AChen, SYRoxburgh, BMartin, JCMaskhulia, LBurdiat, GSalmon, RLomelí, HSadeghi, MSovova, EHautala, ATamuleviciute-Prasciene, EAmbrosetti, MNeubeck, LAsher, EKemps, HEysymontt, ZFarsky, SHayward, JPrescott, EDawkes, SSantibanez, CZeballos, CPavy, BKiessling, ASarrafzadegan, NBaer, CThomas, RHu, DGrace, SL2020-02-07T12:40:16Z2019-082019-08-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.17/3431engEClinicalMedicine. 2019 Jul 3;13:31-45.10.1016/j.eclinm.2019.06.007info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-03-10T09:42:59Zoai:repositorio.chlc.min-saude.pt:10400.17/3431Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T17:20:44.587201Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Cardiac Rehabilitation Availability and Density Around the Globe |
title |
Cardiac Rehabilitation Availability and Density Around the Globe |
spellingShingle |
Cardiac Rehabilitation Availability and Density Around the Globe Turk-Adawi, K HSM CAR Cardiac rehabilitation Capacity Density Global Health Health Services Preventive Cardiology |
title_short |
Cardiac Rehabilitation Availability and Density Around the Globe |
title_full |
Cardiac Rehabilitation Availability and Density Around the Globe |
title_fullStr |
Cardiac Rehabilitation Availability and Density Around the Globe |
title_full_unstemmed |
Cardiac Rehabilitation Availability and Density Around the Globe |
title_sort |
Cardiac Rehabilitation Availability and Density Around the Globe |
author |
Turk-Adawi, K |
author_facet |
Turk-Adawi, K Supervia, M Lopez-Jimenez, F Pesah, E Ding, R Britto, RR Bjarnason-Wehrens, B Derman, W Abreu, A Babu, AS Santos, CA Jong, SK Cuenza, L Yeo, TJ Scantlebury, D Andersen, K Gonzalez, G Giga, V Vulic, Du Vataman, E Cliff, J Kouidi, E Yagci, I Kim, C Benaim, B Estany, ER Fernandez, R Radi, B Gaita, D Simon, A Chen, SY Roxburgh, B Martin, JC Maskhulia, L Burdiat, G Salmon, R Lomelí, H Sadeghi, M Sovova, E Hautala, A Tamuleviciute-Prasciene, E Ambrosetti, M Neubeck, L Asher, E Kemps, H Eysymontt, Z Farsky, S Hayward, J Prescott, E Dawkes, S Santibanez, C Zeballos, C Pavy, B Kiessling, A Sarrafzadegan, N Baer, C Thomas, R Hu, D Grace, SL |
author_role |
author |
author2 |
Supervia, M Lopez-Jimenez, F Pesah, E Ding, R Britto, RR Bjarnason-Wehrens, B Derman, W Abreu, A Babu, AS Santos, CA Jong, SK Cuenza, L Yeo, TJ Scantlebury, D Andersen, K Gonzalez, G Giga, V Vulic, Du Vataman, E Cliff, J Kouidi, E Yagci, I Kim, C Benaim, B Estany, ER Fernandez, R Radi, B Gaita, D Simon, A Chen, SY Roxburgh, B Martin, JC Maskhulia, L Burdiat, G Salmon, R Lomelí, H Sadeghi, M Sovova, E Hautala, A Tamuleviciute-Prasciene, E Ambrosetti, M Neubeck, L Asher, E Kemps, H Eysymontt, Z Farsky, S Hayward, J Prescott, E Dawkes, S Santibanez, C Zeballos, C Pavy, B Kiessling, A Sarrafzadegan, N Baer, C Thomas, R Hu, D Grace, SL |
author2_role |
author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author |
dc.contributor.none.fl_str_mv |
Repositório do Centro Hospitalar Universitário de Lisboa Central, EPE |
dc.contributor.author.fl_str_mv |
Turk-Adawi, K Supervia, M Lopez-Jimenez, F Pesah, E Ding, R Britto, RR Bjarnason-Wehrens, B Derman, W Abreu, A Babu, AS Santos, CA Jong, SK Cuenza, L Yeo, TJ Scantlebury, D Andersen, K Gonzalez, G Giga, V Vulic, Du Vataman, E Cliff, J Kouidi, E Yagci, I Kim, C Benaim, B Estany, ER Fernandez, R Radi, B Gaita, D Simon, A Chen, SY Roxburgh, B Martin, JC Maskhulia, L Burdiat, G Salmon, R Lomelí, H Sadeghi, M Sovova, E Hautala, A Tamuleviciute-Prasciene, E Ambrosetti, M Neubeck, L Asher, E Kemps, H Eysymontt, Z Farsky, S Hayward, J Prescott, E Dawkes, S Santibanez, C Zeballos, C Pavy, B Kiessling, A Sarrafzadegan, N Baer, C Thomas, R Hu, D Grace, SL |
dc.subject.por.fl_str_mv |
HSM CAR Cardiac rehabilitation Capacity Density Global Health Health Services Preventive Cardiology |
topic |
HSM CAR Cardiac rehabilitation Capacity Density Global Health Health Services Preventive Cardiology |
description |
Background: Despite the epidemic of cardiovascular disease and the benefits of cardiac rehabilitation (CR), availability is known to be insufficient, although this is not quantified. This study ascertained CR availability, volumes and its drivers, and density. Methods: A survey was administered to CR programs globally. Cardiac associations and local champions facilitated program identification. Factors associated with volumes were assessed using generalized linear mixed models, and compared by World Health Organization region. Density (i.e. annual ischemic heart disease [IHD] incidence estimate from Global Burden of Disease study divided by national CR capacity) was computed. Findings: CR was available in 111/203 (54.7%) countries; data were collected in 93 (83.8% country response; N = 1082 surveys, 32.1% program response rate). Availability by region ranged from 80.7% of countries in Europe, to 17.0% in Africa (p < .001). There were 5753 programs globally that could serve 1,655,083 patients/year, despite an estimated 20,279,651 incident IHD cases globally/year. Volume was significantly greater where patients were systematically referred (odds ratio [OR] = 1.36, 95% confidence interval [CI] = 1.35-1.38) and programs offered alternative models (OR = 1.05, 95%CI = 1.04-1.06), and significantly lower with private (OR = .92, 95%CI = .91-.93) or public (OR = .83, 95%CI = .82-84) funding compared to hybrid sources.Median capacity (i.e., number of patients a program could serve annually) was 246/program (Q25-Q75 = 150-390). The absolute density was one CR spot per 11 IHD cases in countries with CR, and 12 globally. Interpretation: CR is available in only half of countries globally. Where offered, capacity is grossly insufficient, such that most patients will not derive the benefits associated with participation. |
publishDate |
2019 |
dc.date.none.fl_str_mv |
2019-08 2019-08-01T00:00:00Z 2020-02-07T12:40:16Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10400.17/3431 |
url |
http://hdl.handle.net/10400.17/3431 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
EClinicalMedicine. 2019 Jul 3;13:31-45. 10.1016/j.eclinm.2019.06.007 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Elsevier |
publisher.none.fl_str_mv |
Elsevier |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
instname_str |
Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
repository.mail.fl_str_mv |
|
_version_ |
1799131303740702720 |