Cardiac Rehabilitation

The clinical benefits of cardiac rehabilitation after acute myocardial infarction and revascularisation are well known, and is, as a result, provided throughout the world.  However, there has been limited research into the cost-effectiveness of the current approach, or the potential gains from increasing uptake.  Internationally uptake is poor, with levels ranging from 10% to 60%, and the impact of inequality significant, with uptake almost 40% greater in the least deprived.  

In this research we produced a de-novo mathematical model to explore the cost-effectiveness of cardiac rehabilitation given the effectiveness demonstrated in the latest Cochrane review.  We concluded that CR was cost-effective, with the potential to save 20,000 lives and 50,000 hospital admissions over a 10 year period if uptake was increased to the 85% target.  However, we found that current provision was worsening health inequality in the UK.  These findings have had significant impact on policy discussions, being referenced as the primary motivation for increasing uptake in England in both the NHS Long Term Plan and the BHF’s Turning Back the Tide Framework.

Contact: Seb Hinde I sebastian.hinde@york.ac.uk