Article

While cardiac rehabilitation in patients with ischaemic heart disease
and heart failure is considered cost-effective, this evidence may not be
transferable to heart valve surgery patients.
The aim of this study was to
investigate the cost-effectiveness of cardiac rehabilitation following heart
valve surgery. Design We conducted a cost-utility analysis based on a randomised
controlled trial of 147 patients who had undergone heart valve surgery and were
followed for 6 months. Methods : Patients were randomised to cardiac rehabilitation
consisting of 12 weeks of physical exercise training and monthly
psycho-educational consultations or to usual care. Costs were measured from a
societal perspective and quality-adjusted life years were based on the EuroQol
five-dimensional questionnaire (EQ-5D). Estimates were presented as means and 95%
confidence intervals (CIs) based on bootstrapping.
Costs and effect differences
were presented in a cost-effectiveness plane and were transformed into net
benefit and presented in cost-effectiveness acceptability curves. Results No
statistically significant differences were found in total societal costs (-1609
Euros; 95% CI: -6162 to 2942 Euros) or in quality-adjusted life years (-0.000;
95% CI -0.021 to 0.020) between groups. However, approximately 70% of the cost
and effect differences were located below the x-axis in the cost-effectiveness
plane, and the cost-effectiveness acceptability curves showed that the
probability for cost- effectiveness of cardiac rehabilitation compared to usual
care is at minimum 75%, driven by a tendency towards costs savings. Conclusions:
Cardiac rehabilitation after heart valve surgery may not have improved
health-related quality of life in this study, but is likely to be cost-effective
for society, outweighing the extra costs of cardiac rehabilitation.

Langue : ANGLAIS