Please use this identifier to cite or link to this item: http://hdl.handle.net/1843/41157
Type: Artigo de Periódico
Title: Cardiac rehabilitation availability and delivery in Brazil: a comparison to other upper middle-income countries
Authors: Raquel Rodrigues Britto
Marta Supervia
Karam Turk-Adawi
Gabriela Suéllen da Silva Chaves
Ella Pesah
Francisco Lopez-Jimenez
Danielle Aparecida Gomes Pereira
Artur Haddad Herdy
Sherry Grace
Abstract: Background: Brazil has insufficient cardiac rehabilitation capacity, yet density and regional variation in unmet need is unknown. Moreover, South America has CR guidelines, but whether delivery conforms has not been described. Objective: This study aimed to establish: (1) cardiac rehabilitation volumes and density, and (2) the nature of programmes, and (3) compare these by: (a) Brazilian region and (b) to other upper middle-income countries (upper-MICs). Methods: In this cross-sectional study, a survey was administered to cardiac rehabilitation programmes globally. Cardiac associations were engaged to facilitate programme identification. Density was computed using Global Burden of Disease study ischaemic heart disease incidence estimates. Results were compared to data from the 29 upper-MICs with cardiac rehabilitation (N=249 programmes). Results: Cardiac rehabilitation was available in all Brazilian regions, with 30/75 programmes initiating a survey (40.0% programme response rate). There was only one cardiac rehabilitation spot for every 99 ischaemic heart disease patient. Most programmes were funded by government/hospital sources (n=16, 53.3%), but in 11 programmes (36.7%) patients depended on private health insurance. Guideline-indicated conditions were accepted in ≥70% of programmes. Programmes had a team of 3.8±1.9 staff (versus 5.9±2.8 in other upper-MICs, p<0.05), offering 4.0±1.6/10 core components (versus 6.0±1.5 in other upper-MICs, p<0.01; more tobacco cessation and return-to-work counselling needed in particular) over 44.5 sessions/patient (Q25–75=29–65) vs. 32 sessions/patient (Q25–75=15–40) in other upper-MICs (p<0.01). Conclusion: Brazilian cardiac rehabilitation capacity must be augmented, but where available, services are consistent across regions, but differ from other upper-MICs in terms of staff size and core components delivered.
Subject: Reabilitação cardíaca
Serviços de saúde
Renda nacional
Brasil
language: eng
metadata.dc.publisher.country: Brasil
Publisher: Universidade Federal de Minas Gerais
Publisher Initials: UFMG
metadata.dc.publisher.department: EEF - DEPARTAMENTO DE FISIOTERAPIA
Rights: Acesso Aberto
metadata.dc.identifier.doi: https://doi.org/10.1016/j.bjpt.2019.02.011
URI: http://hdl.handle.net/1843/41157
Issue Date: Mar-2019
metadata.dc.url.externa: http://www.rbf-bjpt.org.br/en-cardiac-rehabilitation-availability-delivery-in-articulo-S1413355518309456
metadata.dc.relation.ispartof: Brazilian Journal of Physical Therapy
Appears in Collections:Artigo de Periódico

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