[Ambulatory rehabilitation after myocardial infarct in Austria]

Cardiac rehabilitation after myocardial infarction has a positive effect on the patient's quality of life and on the prognosis of the disease as well. The cost-saving effect is of importance from the socioeconomical viewpoint. A measurable benefit of such rehabilitation programs can only be achieved by long-term comprehensive care, however. Therefore a hospital rehabilitation program should be followed by regular participation in a long-term community rehabilitation program. The network of cardiac rehabilitation centres in Austria is highly developed and consequently it is possible for every insured patient to be placed for inpatient follow-up therapy on recovering from myocardial infarction. On the other hand, the long-term community cardiac rehabilitation programs are organized only on a sketchy and small scale. A survey amongst patients after myocardial infarction carried out all over Austria showed that 700 patients are currently being treated in 56 community programs. The sponsorship varies a lot. A majority of these groups is organized and financed by the patients themselves. The medical and physiotherapeutic services are mainly organized by the patients as well. They are only partly trained for their task. The care programs take place on a regular basis and the provided services appear adequate, some groups excepted. Medical follow-up examinations to evaluate progress hardly exist. Therefore, quality control of the work in the community programs is not possible at the moment in Austria. A well-organized community care rehabilitation program covering the whole region exists only in Vorarlberg. This program mainly follows the "Feldkircher Modell". The results of this study indicate the urgent necessity to establish additional community care programs for outpatient cardiac rehabilitation in Austria. Furthermore, a common register of the groups, a common organisational model and sponsorship, as well as quality control based on regular medical examination of the patients are essential requirements. A constant exchange of experience with the inpatient rehabilitation centres is to be recommended as well.