Key result
Cardiac rehabilitation in South-East Asia was more often located in tertiary care centers (78.1% vs 46.1%, P<0.001) and required out-of-pocket payment (73.3% vs 36.2%, P<0.001) than global programs.
Why the study?
To establish cardiac rehabilitation availability, density, and program characteristics in South-East Asian Region countries, and compare them with other regions globally.
Cross-Sectional (n=1,114)
Yes
There is a severe shortage of cardiac rehabilitation capacity in South-East Asia compared to global averages, with higher rates of private funding and out-of-pocket patient costs.
Background: The aims of this study were to establish cardiac rehabilitation (CR) availability and density, as well as the nature of programs in South-East Asian Region (SEAR) countries, and to compare this with other regions globally. Methods: In 2016/2017, the International Council of Cardiovascular Prevention and Rehabilitation engaged cardiac associations to facilitate program identification globally. An online survey was administered to identify programs using REDCap, assessing capacity and characteristics. CR density was computed using Global Burden of Disease study annual ischemic heart disease (IHD) incidence estimates. The program audit was updated in 2020. Results: CR was available in 6/11 (54.5%) SEAR countries. Data were collected in 5 countries (83.3% country response); 32/69 (68.1% response rate from 2016/2017) programs completed the survey. These data were compared to 1082 (32.1%) programs in 93/111 (83.3%) countries with CR. Across SEAR countries, there was only one CR spot per 283 IHD patients (vs. 12 globally), with an unmet regional need of 4,258,968 spots annually. Most programs were in tertiary care centers (n = 25, 78.1%; vs. 46.1% globally, P < 0.001). Most were funded privately (n = 17, 56.7%; vs. 17.9%, P < 0.001), and 22 (73.3%) patients were paying out of pocket (vs. 36.2% globally; P < 0.001). The mean number of staff on the multidisciplinary teams was 5.5 ± 3.0 (vs. 5.9 ± 2.8 globally P = 0.268), offering 8.6 ± 1.7/11 core components (consistent with other countries) over 16.8 ± 12.6 h (vs. 36.2 ± 53.3 globally, P = 0.01). Conclusion: Funded CR capacity must be augmented in SEAR. Where available, services were consistent with guidelines, and other regions of the globe, despite programs being shorter than other regions.
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Chowdhury et al. (2021) conducted a cross-sectional in Cardiac rehabilitation (n=1,114). Cardiac rehabilitation programs in South-East Asia vs. Cardiac rehabilitation programs globally was evaluated on Location in tertiary care centers (p=<0.001). Cardiac rehabilitation in South-East Asia was more often located in tertiary care centers (78.1% vs 46.1%, P<0.001) and required out-of-pocket payment (73.3% vs 36.2%, P<0.001) than global programs.
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