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Cardiac rehabilitation availability and density around the globe |
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| Author: | Turk-Adawi, Karam1; Supervia, Marta2,3; Lopez-Jimenez, Francisco3; |
| Organizations: |
1QU Health, Qatar University, Al Jamiaa St, Doha, Qatar 2Gregorio Marañón General University Hospital, Gregorio Marañón Health Research Institute, Dr. Esquerdo, 46, 28007 Madrid, Spain 3Mayo Clinic, Rochester, 200 First St. SW, Rochester, MN 55905, USA
4York University, 4700 Keele Street, Toronto, Ontario M3J1P3, Canada
5Peiking University People' Hospital, 11 Xizhimen S St, Xicheng Qu, Beijing Shi, China 6Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627 - Pampulha, Belo Horizonte, MG 31270-901, Brazil 7Institute for Cardiology and Sports Medicine, Dep. Preventive and Rehabilitative Sport Medicine and Exercise Physiology, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany 8Stellenbosch University & International Olympic Committee Research Center South Africa, Francie Van Zijl Drive, Stellenbosch 7599, South Africa 9Hospital Santa Marta, 1169-024, R. de Santa Marta 50, Lisbon, Portugal 10Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal - 576104, Karnataka 11Mediagnóstica Duitama, Cra16 #14- 68 oficina 201, Duitama, Boyacá, Colombia 12Hospital Raja Isteri Pengiran Anak Saleha, Bandar Seri Begawan BA1710, Brunei 13Philippine Heart Center, East Avenue, Quezon City, Philippines 1100 14National University Heart Centre Singapore, National University Health System (NUHS) Tower Block, 1E Kent Ridge Road, Level 9, Cardiac Department, Singapore 119228, Singapore 15University of the West Indies at Cave Hill, St. Michael, Barbados 16University of Iceland, Saemundargata 2, IS-101, Reykjavik, Iceland 17Central Hospital of Social Security Institute, Asuncion, Paraguay 18Institute of Cardiovascular Diseases, Clinical Center of Serbia, Dr. Koste Todorovića 8, 11000 Beograd, Serbia 19University of Banja Luka, Faculty of Medicine, Save Mrkalja 14, 78000 Banja Luka, Bosnia and Herzegovina 20Institute of Cardiology, Str. Testemitanu, 20, Chisinau, Republic of Moldova 21Betsi Cadwaladr University Health Board, Wrexham Maelor Hospital, Croesnewydd Road, Wrexham LL13 7TD, Wales, United Kingdom 22Laboratory of Sports Medicine, Aristotle University of Thessaloniki, Thessaloniki 57001, Greece 23Marmara University, School of Medicine, Department of Physical Medicine and Rehabilitation, Fevzi Çakmak Mah Muhsin Yazıcıoğlu Cad. No:10 Üst Kaynarca Pendik / İstanbul, Turkey 24Sanggye Paik Hospital, Inje University, Dongil-ro 1342, Nowon-gu, Seoul, Republic of Korea 25ASCARDIO, 17 Callejón 12, Barquisimeto 3001, Lara, Venezuela 26ICCCV Instituto de Cardiología y Cirugía Cardiovascular, No. 702 entre A y Paseo, Vedado, Calle 17, La Habana, Cuba 27INCOR Instituto Nacional Cardiovascular, Jirón Coronel Zegarra, Jesus Maria, Lima 11, Peru 28National Cardiovascular Center Harapan Kita, Kav 87, Jl. Letjen. S. Parman, Jakarta, Indonesia 29University of Medicine & Pharmacy "Victor Babes "Cardiovascular Prevention & Rehabilitation Clinic, Bvd CD Loga 49, 300020 Timisoara, Romania 30State Hospital for Cardiology, Balatonfüred, Gyógy tér 2, 8230, Hungary 31Fu Jen Catholic University Hospital and School of Medicine, College of Medicine, Fu Jen Catholic University, No. 69, Guizi Road, Taishan District, New Taipei City 24352, Taiwan 32The University of Auckland, 71 Merton Road, Private Bag 92019, Auckland 1142, New Zealand 3312 Octubre Universitary Hospital, Av. Cordoba, s/n, 28041 Madrid, Spain 34Tbilisi State Medical University, 33 Vazha Pshavela Ave, Tbilisi, Georgia 35Spanish Association Hospital, 11200, Bulevar Gral. Artigas, 1471 Montevideo, Uruguay 36PHYSIS Prevencion Cardiovascular, Cdla Bolivariana Av. del Libertador - Mz I Villa 5, Guayaquil, Ecuador 37Instituto Nacional de Cardiología, Belisario Domínguez Sección 16, Belisario Domínguez Secc 16, 14080 Tlalpan, CDMX, Mexico 38Cardiac Rehabilitation Research Centre, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Hezar-Jerib Ave., Isfahan, IR 81746 73461, Iran 39University of Palacky, University Hospital Olomouc, I.P. Pavlova 185/6, Nová Ulice, 779 00 Olomouc, Czech Republic 40Cardiovascular Research Group, Division of Cardiology, Oulu University Hospital, University of Oulu, Finland 41Lithuanian University of Health Sciences, A. Mickevičiaus g. 9, Kaunas 44307, Lithuania 42Istituti Clinici Scientifici Maugeri, Care and Research Institute, Department of Cardiac Rehabilitation, Pavia, Italy 43Edinburgh Napier University, 9 Sighthill Ct, Edinburgh EH11 4BN, Scotland, United Kingdom 44Shaare Zedek Medical Center, the Hebrew University, Jerusalem, Israel 45Maxima Medical Centre, De Run 4600, 5504, DB, Veldhoven, Netherlands 46Ślaskie Centrum Rehabilitacji w Ustroniu, Zdrojowa 6, 43-450 Ustroń, Poland 47Heart House Martin, Bagarova 30, Martin (Podháj), Slovakia 48Norfolk and Norwich University Hospital, Colney Lane, Norwich NR4 7UY, United Kingdom 49Bispebjerg Frederiksberg Hospital, Bispebjerg Bakke 23, 2400 København, NV, Copenhagen, Denmark 50Sociedad Chilena de Cardiología, Alfredo Barros Errázuriz 1954, Providencia, Región Metropolitana, Chile 51Cardiovascular Institute of Buenos Aires, Av. del Libertador 6302, 1428 Buenos Aires, Argentina 52Loire-Vendée-Océan hospital, Boulevard des Régents, 44270 Machecoul, France 53Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Stockholm, Sweden 54University of British Columbia,2206 East Mall, Vancouver, BC V6T 1Z3, Canada 55Moncton Hospital, 135 Macbeath Ave, Moncton, NB E1C 6Z8, Canada 56Beijing United Family Hospital, 2 Jiangtai Rd, Chaoyang Qu, Beijing Shi, China, 100096 57KITE-University Health Network, 399 Bathurst St, Toronto, ON M5T 2S8, Canada |
| Format: | article |
| Version: | published version |
| Access: | open |
| Online Access: | PDF Full Text (PDF, 1.5 MB) |
| Persistent link: | http://urn.fi/urn:nbn:fi-fe202003198543 |
| Language: | English |
| Published: |
Elsevier,
2019
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| Publish Date: | 2020-03-19 |
| Description: |
AbstractBackground: Despite the epidemic of cardiovascular disease and the benefits of cardiac rehabilitation (CR), availability is known to be insufficient, although this is not quantified. This study ascertained CR availability, volumes and its drivers, and density. Methods: A survey was administered to CR programs globally. Cardiac associations and local champions facilitated program identification. Factors associated with volumes were assessed using generalized linear mixed models, and compared by World Health Organization region. Density (i.e. annual ischemic heart disease [IHD] incidence estimate from Global Burden of Disease study divided by national CR capacity) was computed. Findings: CR was available in 111/203 (54.7%) countries; data were collected in 93 (83.8% country response; N = 1082 surveys, 32.1% program response rate). Availability by region ranged from 80.7% of countries in Europe, to 17.0% in Africa (p < 0.001). There were 5753 programs globally that could serve 1,655,083 patients/year, despite an estimated 20,279,651 incident IHD cases globally/year. Volume was significantly greater where patients were systematically referred (odds ratio [OR] = 1.36, 95% confidence interval [CI] = 1.35–1.38) and programs offered alternative models (OR = 1.05, 95%CI = 1.04–1.06), and significantly lower with private (OR = 0.92, 95%CI = 0.91–0.93) or public (OR = 0.83, 95%CI = 0.82–0.84) funding compared to hybrid sources. Median capacity (i.e., number of patients a program could serve annually) was 246/program (Q25–Q75 = 150–390). The absolute density was one CR spot per 11 IHD cases in countries with CR, and 12 globally. Interpretation: CR is available in only half of countries globally. Where offered, capacity is grossly insufficient, such that most patients will not derive the benefits associated with participation. see all
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| Series: |
EClinicalMedicine |
| ISSN: | 2589-5370 |
| ISSN-E: | 2589-5370 |
| ISSN-L: | 2589-5370 |
| Volume: | 13 |
| Pages: | 31 - 45 |
| DOI: | 10.1016/j.eclinm.2019.06.007 |
| OADOI: | https://oadoi.org/10.1016/j.eclinm.2019.06.007 |
| Type of Publication: |
A1 Journal article – refereed |
| Field of Science: |
3121 General medicine, internal medicine and other clinical medicine |
| Subjects: | |
| Funding: |
This research was supported by a grant from York University's Faculty of Health. The funder had no role in study design, data collection, data analysis, interpretation or writing of the report. |
| Copyright information: |
© 2019 Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
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https://creativecommons.org/licenses/by-nc-nd/4.0/ |