University of Oulu

Hautala, A. J., Kiviniemi, A. M., Mäkikallio, T., Koistinen, P., Ryynänen, O.-P., Martikainen, J. A., … Tulppo, M. P. (2016). Economic evaluation of exercise-based cardiac rehabilitation in patients with a recent acute coronary syndrome. Scandinavian Journal of Medicine & Science in Sports, 27(11), 1395–1403. https://doi.org/10.1111/sms.12738

Economic evaluation of exercise-based cardiac rehabilitation in patients with a recent acute coronary syndrome

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Author: Hautala, A. J.1; Kiviniemi, A. M.2; Mäkikallio, T.2;
Organizations: 1Center for Machine Vision and Signal Analysis, Faculty of Information Technology and Electrical Engineering, University of Oulu, Oulu, Finland
2Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
3Social and Health Services, City of Oulu, Oulu, Finland
4Kuopio University Hospital, University of Eastern Finland, Kuopio, Finland
5Pharmacoeconomics & Outcomes Research Unit, School of Pharmacy, University of Eastern Finland, Kuopio, Finland
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 0.6 MB)
Persistent link: http://urn.fi/urn:nbn:fi-fe2019091027592
Language: English
Published: John Wiley & Sons, 2017
Publish Date: 2019-09-10
Description:

Abstract

Health care decision‐making requires evidence of the cost‐effectiveness of medical therapies. We evaluated the cost‐effectiveness of exercise‐based cardiac rehabilitation (ECR) implemented according to guidelines. All the patients (n = 204) had experienced a recent acute coronary syndrome and were randomized to a 1‐year ECR (n = 109) or usual care (UC) group (n = 95). The patients’ health‐related quality of life was followed using the 15D instrument and health care costs were collected from electronic health registries. The cost‐effectiveness of ECR was estimated based on intervention and health care costs and quality‐adjusted life years (QALYs) gained. The total average cost per patient was lower in ECR than in UC. The incremental cost was divided by the baseline‐adjusted incremental QALYs (0.045), yielding an incremental cost‐effectiveness ratio of −€24511/QALYs. A combined endpoint of mortality, recurrent coronary event, or hospitalization for a heart failure occurred for five patients in ECR and 16 patients in UC (HR 3.9, 95% CI 1.4–10.6, P = 0.004, relative risk reduction 73%, number needed to treat eight). ECR is a dominant treatment option and decreases the occurrence of adverse cardiac events. These results are useful for decision‐making when planning optimal utilization of resources in Finnish health care.

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Series: Scandinavian journal of medicine & science in sports
ISSN: 0905-7188
ISSN-E: 1600-0838
ISSN-L: 0905-7188
Volume: 27
Issue: 11
Pages: 1395 - 1403
DOI: 10.1111/sms.12738
OADOI: https://oadoi.org/10.1111/sms.12738
Type of Publication: A1 Journal article – refereed
Field of Science: 315 Sport and fitness sciences
Subjects:
Funding: This study was supported by a grant from the Academy of Finland and by the Organisation for Respiratory Health in Finland.
Copyright information: © 2016 John Wiley & Sons A/S. This is the peer reviewed version of the following article: Hautala, A. J., Kiviniemi, A. M., Mäkikallio, T., Koistinen, P., Ryynänen, O.-P., Martikainen, J. A., … Tulppo, M. P. (2016). Economic evaluation of exercise-based cardiac rehabilitation in patients with a recent acute coronary syndrome. Scandinavian Journal of Medicine & Science in Sports, 27(11), 1395–1403. https://doi.org/10.1111/sms.12738, which has been published in final form at https://doi.org/10.1111/sms.12738. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.