Cardiac rehabilitation costs.

Area of Science:

• Cardiology
• Health Economics
• Public Health

Background:

• Cardiac rehabilitation (CR) offers significant clinical and economic benefits but suffers from low patient uptake.
• Capacity expansion hinges on implementing more cost-effective CR delivery models.

Purpose of the Study:

• To delineate the costs associated with delivering CR.
• To explore strategies for reducing CR delivery costs.
• To examine the implications of cost-reduction strategies.

Main Methods:

• A comprehensive literature search was conducted across major databases (MEDLINE, Embase, CDSR, Google Scholar, Scopus).
• Information scientists developed the search strategy.
• Cost data were extracted and qualitatively synthesized.

Main Results:

• Significant global cost variation exists for CR delivery; 55% of countries have patients bearing out-of-pocket expenses.
• Supervised CR costs range widely: PPP$294-12,409 in high-income countries and PPP$146-1095 in middle-income countries.
• Key cost drivers include facilities, personnel, and session frequency. Strategies like using information and communication technology (ICT), reducing session doses, and employing lower-cost personnel/equipment can reduce costs, but few explicit low-cost models are published.

Conclusions:

• Further research is essential on community-based CR costs, cost-effectiveness in diverse global settings, and CR's impact on return-to-work.
• Standardization and efficacy testing of a low-cost CR model across multiple healthcare systems are recommended.