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Updated: May 11, 2026
A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
Published on: April 19, 2019
Cardiac Rehabilitation for Persons with Stroke: A Cost-Effectiveness Analysis
Jessica Ruff1, Belinda Udeh2,3, Susan Linder4,5,6
1Cleveland Clinic, Preventive Medicine, Wellness Institute, Cleveland, OH, USA.
Insights
Cardiac rehabilitation is a cost-effective strategy for individuals with stroke, improving quality-adjusted life years (QALYs) and offering superior outcomes compared to usual care.
Area of Science:
- Health Economics
- Neurology
- Rehabilitation Medicine
Background:
- Stroke is a leading cause of disability worldwide.
- Cardiac rehabilitation programs are established for cardiovascular disease but less studied for stroke recovery.
- Cost-effectiveness of interventions is crucial for healthcare resource allocation.
Purpose of the Study:
- To evaluate the cost-effectiveness of a cardiac rehabilitation program for stroke survivors.
- To compare the economic and clinical outcomes of cardiac rehabilitation versus customary care in this population.
Main Methods:
- A 30-year Markov model was utilized to simulate outcomes.
- Health states were defined by modified Rankin Scale scores.
- Quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs) were calculated.
Main Results:
- Cardiac rehabilitation demonstrated superior effectiveness, yielding an additional 3.28 QALYs.
- The incremental cost was $5704, resulting in an ICER of $1740/QALY.
- Sensitivity analyses confirmed cardiac rehabilitation as the optimal strategy.
Conclusions:
- Cardiac rehabilitation is a clinically beneficial and cost-effective intervention for stroke patients.
- This study supports the integration of cardiac rehabilitation into stroke care pathways.
- The findings provide economic justification for cardiac rehabilitation in the stroke population.
Objective:
To investigate the cost-effectiveness of a cardiac rehabilitation program in individuals with stroke compared with customary care.
Design:
A Markov model was created using a 30-year time horizon, with cycle lengths of 1 year to determine the effectiveness and cost-effectiveness of a cardiac rehabilitation program in persons with stroke. Input parameters were based on recently published literature. Health states were defined as degree of disability evaluated by the modified Rankin scale score. Costs were based on recent cost-effectiveness analyses and inflated to 2024 US Dollars using the medical care component of the US Consumer Price Index.
Setting:
Outpatient ambulatory setting.
Participants:
Persons with mild disability after ischemic stroke.
Intervention:
A model comparing cardiac rehabilitation versus usual care was created.
Main Measures:
Quality-adjusted life years (QALYs) were used to measure the effectiveness of cardiac rehabilitation versus usual care. The cost-effectiveness of cardiac rehabilitation versus usual care was compared with respect to incremental costs, incremental effectiveness, and incremental cost-effectiveness ratios (ICERs).
Results:
Cardiac rehabilitation was the superior strategy, resulting in higher incremental effectiveness of 3.28 QALY at an increased incremental cost of $5704. The ICER was $1740/QALY. A two-way sensitivity analysis of these variables had no change, with cardiac rehab remaining the optimal strategy.
Conclusions:
While numerous studies and systematic analyses have reported compelling evidence of the clinical benefits of cardiac rehabilitation for patients with stroke, the current study contributes to the existing body of literature, demonstrating that cardiac rehabilitation is also cost-effective in the stroke population.
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