In-patient exercise-based cardiac rehabilitation was highly cost-effective in cardiovascular disease patients, with a mean cost of 11,258.30 CHF per quality-adjusted life year.
Cohort (n=865)
No
Is in-patient exercise-based cardiac rehabilitation cost-effective in patients with cardiovascular disease?
In-patient exercise-based cardiac rehabilitation appears highly cost-effective at 11,258 CHF per QALY, reinforcing its utility in secondary cardiovascular prevention.
Abstract Background/Introduction The increasing prevalence of Cardiovascular disease (CVD) is associated with rising health costs as well as economic losses. Exercise- based cardiac rehabilitation (EBCR) is an effective intervention to improve functional capacity, independence and quality of life in CVD patients after hospitalization and operations. However, there is a gap of knowledge in the assessment of the cost-efficiency of EBCR. The MacNew Heart questionnaire is a validated and reliable instrument used to quantify health related quality of life in cardiovascular disease patients. Quality- adjusted life year (QALY) is a measurement of cost-effectiveness in health economics, that combines the assessment of quality of life with quantity of life. Purpose To determine the cost-effectiveness of EBCR in in-patient cardiac rehabilitation patients. Methods Patients referred for inpatient EBCR between 2022 and 2024 were analyzed in this retrospective single-center cohort study. Quality of Life was assessed through the MacNew Heart (MNH) questionnaire. The MacNew Heart Questionnaire scores were converted into EQ-5D-5L utilities by estimating mapping algorithms in which EQ-5D-5L utility values served as the dependent variable and MacNew global or domain scores served as predictors. Multiple regression approaches were compared, and ordinary least squares (OLS), the robust MM-estimator and the generalized linear model (GLM) were selected to generate predicted EQ-5D-5L values. QALYs were calculated by taking the mean of the admission and discharge utility scores, multiplying it by the patient's length of stay in years. Results The cohort of 865 patients had a median age of 65 (quartiles 57.0 to 72.0) years, with 22.2% female participants and a median stay of 20 (quartiles 20.0 to 27.0) days. The median MNH global score increased by 0.8/6 points (quartiles 0.3 to 1.2), which corresponds to an EQ-5D-5L- change of 0.11 and a QALY of 0.05 (quartiles 0.04 to 0.06) years. Based on a median rehabilitation cost of 531.76 (quartiles 531.76 to 531.76) CHF per day, the cost per QALY amounts to 11258.30 (quartiles 9359.48 to 13131.85) CHF. Conclusion Considering a mean value of 11258.30 CHF per QALY, EBCR appears highly cost-effective, underscoring its value in secondary cardiovascular prevention.
Silva et al. (Mon,) conducted a cohort in Cardiovascular disease (n=865). In-patient exercise-based cardiac rehabilitation was evaluated on Cost per Quality-Adjusted Life Year (QALY). In-patient exercise-based cardiac rehabilitation was highly cost-effective in cardiovascular disease patients, with a mean cost of 11,258.30 CHF per quality-adjusted life year.