Table 3.
Costs of care 12 months before and after exercise-based cardiac rehabilitation following heart valve surgery
| CR group (n=277) |
No CR group (n=223) |
Difference between group difference | ||||||
|---|---|---|---|---|---|---|---|---|
| Before | After | Difference | Before | After | Difference | p-Value | ||
| Primary care (visits) | ||||||||
| General practitioners | 337 (17) | 544 (23) | 207 (22) | 352 (17) | 569 (25) | 217 (22) | −10.0 (−70 to 50) | 0.74 |
| Medical specialists | 153 (21) | 113 (14) | −40 (18) | 136 (17) | 125 (16) | −11 (23) | −29 (−87 to 28) | 0.31 |
| Physiotherapists | 26 (8) | 26 (10) | 0 (0) | 51 (25) | 38 (16) | −13 (17) | 13 (−22 to 48) | 0.46 |
| Psychologists | 3 (2) | 8 (4) | 5 (5) | 2 (1) | 6 (3) | 4 (3) | 1 (−10 to 11) | 0.93 |
| Other | 93 (6) | 81 (6) | −12 (6) | 83 (6) | 78 (6) | −5 (7) | −7 (−24 to 11) | 0 47 |
| Total | 612 (30) | 773 (32) | 161 (32) | 624 (41) | 817 (35) | 193 (37) | −32 (−126 to 61) | 0.51 |
| Hospital inpatient (admissions) | ||||||||
| Cardiovascular, acute | 3655 (814) | 1656 (392) | −1999 (828) | 3532 (914) | 1862 (312) | −1670 (897) | −329 (−2732 to 2072) | 0.78 |
| Cardiovascular, not acute | 1438 (151) | 675 (243) | −763 (273) | 1931 (308) | 848 (294) | −1083 (399) | 320 (−616 to 1258) | 0.51 |
| Thoracic surgery, acute | 3798 (813) | 469 (314) | −3329 (837) | 2950 (818) | 446 (196) | −2504 (847) | −825 (−3158 to 1508) | 0.48 |
| Thoracic surgery, not acute | 28 902 (904) | 251 (136) | −28 651 (913) | 28 091 (839) | 177 (145) | −27 914 (839) | −737 (−3187 to 1716) | 0.56 |
| Other, acute | 5143 (563) | 2682 (394) | 2461 (602) | 6649 (899) | 3904 (517) | −2745 (1007) | 284 (−2017 to 2585) | 0.81 |
| Other, not acute | 1456 (225) | 1314 (236) | −142 (317) | 2111 (724) | 705 (186) | −1406 (757) | 1264 (−358 to 2883) | 0.13 |
| Total | 44 391 (1806) | 7048 (879) | −37 343 (1766) | 45 264 (2173) | 7942 (847) | −31 321 (2173) | −22 (−5451 to 5406) | 0.99 |
| Hospital outpatient (visits) | ||||||||
| Cardiology | 730 (59) | 909 (101) | 179 (114) | 658 (57) | 610 (78) | −48 (86) | 227 (−47 to 503) | 0.11 |
| Thoracic surgery | 33 (8) | 184 (28) | 151 (27) | 43 (8) | 84 (17) | 41 (19) | 110 (46 to 177) | <0.01 |
| Other | 1945 (265) | 2147 (303) | 202 (177) | 1734 (121) | 1868 (365) | 134 (333) | 68 (−672 to 807) | 0.86 |
| Total | 2707 (273) | 3240 (315) | 533 (209) | 2435 (139) | 2561 (376) | 126 (342) | 407 (−378 to 1191) | 0.29 |
| Pharmaceuticals (drug categories) | ||||||||
| ACE-inhibitors | 9 (1.2) | 11 (1) | 2 (1) | 11 (2) | 12 (2) | 1 (1) | 2 (−1 to 6) | 0.23 |
| Antithrombotic | 29 (3) | 59 (18) | 30 (18) | 29 (2) | 34 (5) | 5 (8) | 25 (−14 to 65) | 0.21 |
| β-blockers | 15 (2) | 31 (2) | 16 (2) | 13 (2) | 27 (3) | 14 (3) | 2 (−4 to 9) | 0.47 |
| Spironolactone | 2 (1) | 5 (1) | 3 (1) | 3 (1) | 6 (1) | 3 (1) | 0 (−3 to 2) | 0.68 |
| Lipid modifying | 57 (12) | 86 (13) | 29 (9) | 44 (12) | 69 (14) | 25 (10) | 4 (−23 to 30) | 0.78 |
| Digoxin | 2 (1) | 3 (1) | 1 (1) | 2 (1) | 4 (1) | 2 (1) | −1 (−4 to 1) | 0.21 |
| Diuretics | 24 (4) | 25 (2) | 1 (4) | 24 (3) | 25 (2) | 1 (3) | 0 (−10 to 10) | 0.99 |
| Vitamin K antagonists | 14 (2) | 60 (6) | 46 (6) | 17 (2) | 56 (7) | 39 (6) | 7 (−11 to 25) | 0.45 |
| Psycholeptics | 0 (0) | 0 (0) | 0 (0) | 5 (4) | 11 (5) | 6 (4) | −6 (−13 to 2) | 0.12 |
| Antiarrythmics | 2 (0) | 6 (1) | 4 (1) | 3 (1) | 6 (1) | 3 (1) | 1 (−2 to 4) | 0.36 |
| Analgetics* | 13 (3) | 16 (3) | 3 (2) | 28 (8) | 29 (8) | 1 (6) | 2 (−10 to 13) | 0.76 |
| Other cardiovascular | 43 (6.3) | 25 (4) | −18 (5) | 57 (8) | 24 (4) | −33 (7) | 15 (−2 to 33) | 0.09 |
| Other medication | 256 (26) | 254 (24) | −2 (15) | 305 (35) | 300 (28) | −5 (23) | 3 (−51 to 57) | 0.91 |
| Total | 466 (34) | 581 (35) | 115 (30) | 541 (46) | 602 (39) | 61 (30) | 54 (−28 to 136) | 0.88 |
| Total cost (healthcare) | 48 176 (1897) | 11 641 (960) | −36 535 (1786) | 48 864 (1786) | 11 922 (1040) | −36 943 (2225) | 408 (−5083 to 5896) | 0.89 |
| Sick leave, weeks | 1320 (278) | 4424 (681) | 3104 (561) | 1079 (256) | 3260 (645) | 2181 (503) | 923 (−579 to 2426) | 0.23 |
| Total costs (societal) | 49 496 (1965) | 16 065 (1191) | −33 431 (1925) | 49 943 (2334) | 15 182 (1269) | −34 761 (2290) | 1330 (−4427 to 7086) | 0.65 |
Values are mean costs (SE) and mean differences (95% CI).
*Includes analgetics and topical products with DDD value for joint and muscular pain.
CR, cardiac rehabilitation; DDD, defined daily doses.