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المؤلفMoghei, Mahshid
المؤلفPesah, Ella
المؤلفTurk-Adawi, Karam
المؤلفSupervia, Marta
المؤلفJimenez, Francisco Lopez
المؤلفSchraa, Ellen
المؤلفGrace, Sherry L
تاريخ الإتاحة2019-01-07T06:59:32Z
تاريخ النشر2018-10-01
اسم المنشورInternational Journal of Cardiologyen_US
المعرّفhttp://dx.doi.org/10.1016/j.ijcard.2018.10.089
الاقتباسMoghei M, Pesah E, Turk-Adawi K, Supervia M, Jimenez FL, Schraa E, Grace SL. Funding sources and costs to deliver cardiac rehabilitation around the globe: Drivers and barriers. Int J Cardiol. 2018 Oct 31. pii: S0167-5273(18)34389-4. doi: 10.1016/j.ijcard.2018.10.089.
الرقم المعياري الدولي للكتاب0167-5273
معرّف المصادر الموحدhttp://hdl.handle.net/10576/11247
الملخصCardiac rehabilitation (CR) reach is minimal globally, primarily due to financial factors. This study characterized CR funding sources, cost to patients to participate, cost to programs to serve patients, and the drivers of these costs. In this cross-sectional study, an online survey was administered to CR programs globally. Cardiac associations and local champions facilitated program identification. Costs in each country were reported using purchasing power parity (PPP). Results were compared by World Bank country income classification using generalized linear mixed models. 111/203 (54.68%) countries in the world offer CR, of which data were collected in 93 (83.78% country response rate; N = 1082 surveys, 32.0% program response rate). CR was most-often publicly funded (more in high-income countries [HICs]; p < .001), but in 60.20% of countries patients paid some or all of the cost. Funding source impacted capacity (p = .004), number of patients per exercise session (p < .001), personnel (p = .037), and functional capacity testing (p = .039). The median cost to serve 1 patient was $945.91PPP globally. In low and middle-income countries (LMICs), exercise equipment and stress testing were perceived as the most expensive delivery elements, with front-line personnel costs perceived as costlier in HICs (p = .003). Modifiable factors associated with higher costs included CR team composition (p = .001), stress testing (p = .002) and telemetry monitoring in HICs (p = .01), and not offering alternative models in LMICs (p = .02). Too many patients are paying out-of-pocket for CR, and more public funding is needed. Lower-cost delivery approaches are imperative, and include walk tests, task-shifting, and intensity monitoring via perceived exertion.
اللغةen
الناشرElsevier
الموضوعCardiac rehabilitation
الموضوعCost
الموضوعGlobal health
الموضوعHealth economics
الموضوعHealth policies
العنوانFunding sources and costs to deliver cardiac rehabilitation around the globe: Drivers and barriers.
النوعArticle
الصفحات278-286
رقم المجلد276
ESSN1874-1754


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