Abstract 14614: Comprehensive Cardiac Rehabilitation for Patients With Implantable Cardioverter Defibrillator Seems Cost-saving: Three Year Follow-Up Results From the COPE-ICD Randomized Controlled Trial
Introduction: The COPE-ICD trial tested comprehensive cardiac rehabilitation (CCR) consisting of exercise training and psycho-educational interventions (n=99) compared to usual care (n=97) in implantable cardioverter defibrillator (ICD) patients. After CCR significant differences were found between groups: VO2; intervention 23.01mL/min/kg compared to control 20.79 mL/min/kg (p=0.004), general health (SF-36); intervention mean 63.5 points versus 62.1 in the usual care group (p=0.015) and explorative analyses showed significant differences in mental component score (SF-36) in favour of the CCR group. Three years after randomization economic costs of the CCR program and health care use were investigated.
Hypothesis: Based on improvements in physical and mental health CCR is cost-saving in reducing health care utilization?
Methods: Costs attributable to the intervention were calculated by measuring recorded time spend on the included patients priced by salaries to nurses, physicians and physiotherapists. Other variable costs were included. Calculation only considers operational costs. The three year costs of health care use were extracted from The Danish National Patient Register and The Danish National Health Service Register based on identifiers of the patients included in the trial.
Results: The cost of the CCR program was 490 US$ per person. Costs of hospitalization, visits to GP and use of physiotherapists were higher in the usual care group than in the CCR group. A difference in costs of health care of 7112 US$ per person was estimated in favour of the CCR group (Table 1).
Conclusions: The cost of the CCR program was outweighed by savings in the use of health care. In conclusion, the CCR program seems to be cost-saving. The effect was primarily carried by four patients receiving heart transplantation or LVAD. Discussion: Does rehabilitation prevent progression in heart failure or should these cases be extracted as outliers?
- © 2013 by American Heart Association, Inc.