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AuthorTurk-Adawi, Karam
AuthorSupervia, Marta
AuthorLopez-Jimenez, Francisco
AuthorPesah, Ella
AuthorDing, Rongjing
AuthorBritto, Raquel R
AuthorBjarnason-Wehrens, Birna
AuthorDerman, Wayne
AuthorAbreu, Ana
AuthorBabu, Abraham S
AuthorSantos, Claudia Anchique
AuthorJong, Seng Khiong
AuthorCuenza, Lucky
AuthorYeo, Tee Joo
AuthorScantlebury, Dawn
AuthorAndersen, Karl
AuthorGonzalez, Graciela
AuthorGiga, Vojislav
AuthorVulic, Dusko
AuthorVataman, Eleonora
AuthorCliff, Jacqueline
AuthorKouidi, Evangelia
AuthorYagci, Ilker
AuthorKim, Chul
AuthorBenaim, Briseida
AuthorEstany, Eduardo Rivas
AuthorFernandez, Rosalia
AuthorRadi, Basuni
AuthorGaita, Dan
AuthorSimon, Attila
AuthorChen, Ssu-Yuan
AuthorRoxburgh, Brendon
AuthorMartin, Juan Castillo
AuthorMaskhulia, Lela
AuthorBurdiat, Gerard
AuthorSalmon, Richard
AuthorLomelí, Hermes
AuthorSadeghi, Masoumeh
AuthorSovova, Eliska
AuthorHautala, Arto
AuthorTamuleviciute-Prasciene, Egle
AuthorAmbrosetti, Marco
AuthorNeubeck, Lis
AuthorAsher, Elad
AuthorKemps, Hareld
AuthorEysymontt, Zbigniew
AuthorFarsky, Stefan
AuthorHayward, Jo
AuthorPrescott, Eva
AuthorDawkes, Susan
AuthorSantibanez, Claudio
AuthorZeballos, Cecilia
AuthorPavy, Bruno
AuthorKiessling, Anna
AuthorSarrafzadegan, Nizal
AuthorBaer, Carolyn
AuthorThomas, Randal
AuthorHu, Dayi
AuthorGrace, Sherry L
Available date2019-10-03T05:46:07Z
Publication Date2019-08-01
Publication NameEClinicalMedicine
Identifierhttp://dx.doi.org/10.1016/j.eclinm.2019.06.007
Citation: K. Turk-Adawi, M. Supervia, F. Lopez-Jimenez, et al., Cardiac Rehabilitation Availability and Density around the Globe, , https://doi.org/10.1016/j.eclinm.2019.06.007
URIhttp://hdl.handle.net/10576/12006
AbstractDespite 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. 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. 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 < .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 = .92, 95%CI = .91-.93) or public (OR = .83, 95%CI = .82-84) funding compared to hybrid sources.Median capacity (i.e., number of patients a program 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. 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.
SponsorThis 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.
Languageen
PublisherElsevier
SubjectCapacity
Cardiac rehabilitation
Density
Global health
Health services
Preventive cardiology
TitleCardiac Rehabilitation Availability and Density around the Globe.
TypeArticle
Pagination31-45
Volume Number13
ESSN2589-5370


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