Cardiac rehabilitation in Portugal--developments between 1998 and 2004

Cardiac rehabilitation (CR) has recognized value in cardiovascular disease. However, according to the 1998 survey of the Portuguese Study Group on Exercise Pathophysiology and Cardiac Rehabilitation, it was still underused in Portugal, with much lower referral rates than other European countries. The aim of the present work was to assess developments in CR in Portugal between 1998 and 2004.

A form requesting information on general characteristics, technical staff, program phases and components, and funding, was sent to all CR centers. The rate of referral to CR was calculated by comparing these data with official data from hospital discharges for acute coronary syndromes in 2004.

There was a twofold increase in the number of CR centers, mainly because of new public hospitals. The programs are well organized and have actually been improved in recent years. The overall admission rate in 2004 was 1.5%, which, despite representing an increase compared to 1998, is still much lower than the rates of other European countries. Most of the problems previously reported, including the size and location of centers, training, funding and educational and cultural issues, have not been overcome.

Although there have been some improvements, the number of patients who are referred to CR in Portugal is still too low. It is essential to address and to resolve most of the issues that are limiting patients' access to this treatment.