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Tipo:	Artigo de Periódico
Título:	Cardiac rehabilitation availability and delivery in Brazil: a comparison to other upper middle-income countries
Autor(es):	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
Resumen:	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.
Asunto:	Reabilitação cardíaca Serviços de saúde Renda nacional Brasil
Idioma:	eng
País:	Brasil
Editor:	Universidade Federal de Minas Gerais
Sigla da Institución:	UFMG
Departamento:	EEF - DEPARTAMENTO DE FISIOTERAPIA
Tipo de acceso:	Acesso Aberto
Identificador DOI:	https://doi.org/10.1016/j.bjpt.2019.02.011
URI:	http://hdl.handle.net/1843/41157
Fecha del documento:	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
Aparece en las colecciones:	Artigo de Periódico

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