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Article: A short course of cardiac rehabilitation program is highly cost effective in improving long-term quality of life in patients with recent myocardial infarction or percutaneous coronary intervention

TitleA short course of cardiac rehabilitation program is highly cost effective in improving long-term quality of life in patients with recent myocardial infarction or percutaneous coronary intervention
Authors
KeywordsCosts and cost analysis
Exercise therapy
Myocardial ischemia
Quality of life
Rehabilitation
Issue Date2004
PublisherWB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/apmr
Citation
Archives Of Physical Medicine And Rehabilitation, 2004, v. 85 n. 12, p. 1915-1922 How to Cite?
AbstractYu C-M, Lau C-P, Chau J, McGhee S, Kong S-L, Cheung BM-Y, Li LS-W. A short course of cardiac rehabilitation program is highly cost effective in improving long-term quality of life in patients with recent myocardial infarction or percutaneous coronary intervention. To evaluate the long-term effect of a cardiac rehabilitation and prevention program (CRPP) on quality of life (QOL) and its cost effectiveness. Prospective, randomized controlled trial. University-affiliated outpatient cardiac rehabilitation and prevention center. A total of 269 patients (76% men; mean age, 64±11y) with recent acute myocardial infarction (AMI; n=193) or after elective percutaneous coronary intervention (PCI; n=76) were randomized in a ratio of 2 to 1. Patients received either CRPP (an 8-wk exercise and education class in phase 2) or conventional therapy without exercise program (control group). They were followed until they had completed all 4 phases of the program (ie, 2y). QOL assessments, by using the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) and Symptoms Questionnaire, were performed at the end of each phase. Direct health care cost was calculated, whereas cost utility was estimated as money spent (in US$) per quality-adjusted life-year (QALY) gained. In the CRPP group, 6 of the 8 SF-36 dimensions improved significantly by phase 2 and were maintained throughout the study period. Patients were less anxious and depressed, and felt more relaxed and contented. In the control group, none of the SF-36 dimensions were improved by phase 2, and bodily pain was increased. In phase 4, only 4 dimensions were improved. Symptoms were unchanged except for increased hostility score. There was a significant gain in net time trade-off in the CRPP group after phase 2. The direct health care expenses in the CRPP and control groups were $15,292 and $15,707 per patient, respectively. Therefore, the cost utility calculated was $640 saved per QALY gained. Savings attributable to CRPP were primarily explained by the lower rate (13% vs 26% of patients, χ 2 test=3.9, P<.05) and cost of subsequent PCI (P=.01). In an era of managing patients with coronary heart disease, a short-course CRPP was highly cost effective in providing better QOL to patients with recent AMI or after elective PCI. In addition, the improvement of QOL was quick and sustained for at least 2 years after CRPP. © 2004 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.
Persistent Identifierhttp://hdl.handle.net/10722/86715
ISSN
2015 Impact Factor: 3.045
2015 SCImago Journal Rankings: 1.427
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorYu, CMen_HK
dc.contributor.authorLau, CPen_HK
dc.contributor.authorChau, Jen_HK
dc.contributor.authorMcGhee, Sen_HK
dc.contributor.authorKong, SLen_HK
dc.contributor.authorCheung, BMYen_HK
dc.contributor.authorLi, LSWen_HK
dc.date.accessioned2010-09-06T09:20:26Z-
dc.date.available2010-09-06T09:20:26Z-
dc.date.issued2004en_HK
dc.identifier.citationArchives Of Physical Medicine And Rehabilitation, 2004, v. 85 n. 12, p. 1915-1922en_HK
dc.identifier.issn0003-9993en_HK
dc.identifier.urihttp://hdl.handle.net/10722/86715-
dc.description.abstractYu C-M, Lau C-P, Chau J, McGhee S, Kong S-L, Cheung BM-Y, Li LS-W. A short course of cardiac rehabilitation program is highly cost effective in improving long-term quality of life in patients with recent myocardial infarction or percutaneous coronary intervention. To evaluate the long-term effect of a cardiac rehabilitation and prevention program (CRPP) on quality of life (QOL) and its cost effectiveness. Prospective, randomized controlled trial. University-affiliated outpatient cardiac rehabilitation and prevention center. A total of 269 patients (76% men; mean age, 64±11y) with recent acute myocardial infarction (AMI; n=193) or after elective percutaneous coronary intervention (PCI; n=76) were randomized in a ratio of 2 to 1. Patients received either CRPP (an 8-wk exercise and education class in phase 2) or conventional therapy without exercise program (control group). They were followed until they had completed all 4 phases of the program (ie, 2y). QOL assessments, by using the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) and Symptoms Questionnaire, were performed at the end of each phase. Direct health care cost was calculated, whereas cost utility was estimated as money spent (in US$) per quality-adjusted life-year (QALY) gained. In the CRPP group, 6 of the 8 SF-36 dimensions improved significantly by phase 2 and were maintained throughout the study period. Patients were less anxious and depressed, and felt more relaxed and contented. In the control group, none of the SF-36 dimensions were improved by phase 2, and bodily pain was increased. In phase 4, only 4 dimensions were improved. Symptoms were unchanged except for increased hostility score. There was a significant gain in net time trade-off in the CRPP group after phase 2. The direct health care expenses in the CRPP and control groups were $15,292 and $15,707 per patient, respectively. Therefore, the cost utility calculated was $640 saved per QALY gained. Savings attributable to CRPP were primarily explained by the lower rate (13% vs 26% of patients, χ 2 test=3.9, P<.05) and cost of subsequent PCI (P=.01). In an era of managing patients with coronary heart disease, a short-course CRPP was highly cost effective in providing better QOL to patients with recent AMI or after elective PCI. In addition, the improvement of QOL was quick and sustained for at least 2 years after CRPP. © 2004 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.en_HK
dc.languageengen_HK
dc.publisherWB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/apmren_HK
dc.relation.ispartofArchives of Physical Medicine and Rehabilitationen_HK
dc.subjectCosts and cost analysisen_HK
dc.subjectExercise therapyen_HK
dc.subjectMyocardial ischemiaen_HK
dc.subjectQuality of lifeen_HK
dc.subjectRehabilitationen_HK
dc.subject.meshAngioplasty, Balloon, Coronary - economics - rehabilitationen_HK
dc.subject.meshCost-Benefit Analysisen_HK
dc.subject.meshExercise Therapy - economicsen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHealth Care Costsen_HK
dc.subject.meshHong Kongen_HK
dc.subject.meshHumansen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshMyocardial Infarction - economics - psychology - therapyen_HK
dc.subject.meshOutcome and Process Assessment (Health Care) - economicsen_HK
dc.subject.meshPatient Education as Topic - economicsen_HK
dc.subject.meshProspective Studiesen_HK
dc.subject.meshQuality of Lifeen_HK
dc.subject.meshQuality-Adjusted Life Yearsen_HK
dc.titleA short course of cardiac rehabilitation program is highly cost effective in improving long-term quality of life in patients with recent myocardial infarction or percutaneous coronary interventionen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0003-9993&volume=85&issue=12&spage=1915&epage=22&date=2004&atitle=A+short+course+of+cardiac+rehabilitation+program+is+highly+cost+effective+in+improving+long-term+quality+of+life+in+patients+with+recent+myocardial+infarction+or+percutaneous+coronary+interventionen_HK
dc.identifier.emailMcGhee, S:smmcghee@hkucc.hku.hken_HK
dc.identifier.emailCheung, BMY:mycheung@hku.hken_HK
dc.identifier.authorityMcGhee, S=rp00393en_HK
dc.identifier.authorityCheung, BMY=rp01321en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.apmr.2004.05.010en_HK
dc.identifier.pmid15605326-
dc.identifier.scopuseid_2-s2.0-9944222733en_HK
dc.identifier.hkuros101379en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-9944222733&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume85en_HK
dc.identifier.issue12en_HK
dc.identifier.spage1915en_HK
dc.identifier.epage1922en_HK
dc.identifier.isiWOS:000225609400003-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridYu, CM=7404976646en_HK
dc.identifier.scopusauthoridLau, CP=7401968501en_HK
dc.identifier.scopusauthoridChau, J=36941253500en_HK
dc.identifier.scopusauthoridMcGhee, S=7003288588en_HK
dc.identifier.scopusauthoridKong, SL=7203044824en_HK
dc.identifier.scopusauthoridCheung, BMY=7103294806en_HK
dc.identifier.scopusauthoridLi, LSW=7501450364en_HK

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