Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Sep 6:16:471.
doi: 10.1186/s12913-016-1658-1.

Advocacy for outpatient cardiac rehabilitation globally

Abraham Samuel Babu  1 , Francisco Lopez-Jimenez  2 , Randal J Thomas  2 , Wanrudee Isaranuwatchai  3   4 , Artur Haddad Herdy  5 , Jeffrey S Hoch  3   4 , Sherry L Grace  6   7 ; in conjunction with the International Council of Cardiovascular Prevention and Rehabilitation (ICCPR)
Affiliations

Advocacy for outpatient cardiac rehabilitation globally

Abraham Samuel Babu et al. BMC Health Serv Res. .

Abstract

Background: Cardiovascular diseases (CVD) are the leading cause of death globally. Cardiac rehabilitation (CR) is an evidence-based intervention recommended for patients with CVD, to prevent recurrent events and to improve quality of life. However, despite the proven benefits, only a small percentage of those would benefit from CR actually receive it worldwide. This paper by the International Council of Cardiovascular Prevention and Rehabilitation forwards the groundwork for successful CR advocacy to achieve broader reimbursement, and hence implementation.

Methods: First, the results of the International Council's survey on national CR reimbursement policies by government and insurance companies are summarized. Second, a multi-faceted approach to CR advocacy is forwarded. Finally, as per the advocacy recommendations, the economic impact of CVD and the corresponding benefits of CR and its cost-effectiveness are summarized. This provides the case for CR reimbursement advocacy.

Results: Thirty-one responses were received, from 25 different countries: 18 (58.1 %) were from high-income countries, 10 (32.4 %) from upper middle-income, and 3 (9.9 %) from lower middle-income countries. When asked who reimburses at least some portion of CR services in their country, 19 (61.3 %) reported the government, 17 (54.8 %) reported patients pay out-of-pocket, 16 (51.6 %) reported insurance companies, 12 (38.7 %) reported that it is shared between the patient and another source, and 7 (22.6 %) reported another source.

Conclusions: Many patients pay out-of-pocket for CR. CR reimbursement around the world is inconsistent and insufficient. Advocacy campaigns forwarding the CR cause, supported by the relevant literature, enlisting sources of support in a unified manner with an organized plan, are needed, and must be pursued persistently.

Keywords: Cardiac rehabilitation; Cardiovascular disease; Insurance; Reimbursement.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Member association of the International Council of Cardiovascular Prevention and Rehabilitation
See this image and copyright information in PMC

References

    1. World Health Organization; World Heart Federation; World Stroke Organization . Global atlas on CVD prevention and control. Geneva: WHO; 2011.
    1. Bloom DE, Cafiero, ET, Jané-Llopis E, Abrahams-Gessel S, Bloom, LR, Fathima, S, et al. The World Economic Forum and Harvard School of Public Health. The global economic burden of non-communicable diseases. 2011. http://www3.weforum.org/docs/WEF_Harvard_HE_GlobalEconomicBurdenNonCommu.... Accessed 24 Sept 2015
    1. World Health Organization. The global burden of disease: 2004 update. http://www.who.int/healthinfo/global_burden_disease/2004_report_update/e... 29 Sept 2015.
    1. Murray CJ, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C, et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380:2197–223. doi: 10.1016/S0140-6736(12)61689-4. - DOI - PubMed
    1. Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380:2163–96. doi: 10.1016/S0140-6736(12)61729-2. - DOI - PMC - PubMed

MeSH terms