Healthcare resource utilisation and sick leave 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 | 15.7 (0.7) | 25.3 (0.9) | 9.6 (0.8) | 17.1 (0.8) | 27.1 (1.1) | 10.1 (0.9) | 0.5 (−2.9 to 1.9) | 0.67 |
| Medical specialists | 0.5 (0.0) | 0.5 (0.0) | 0.0 (0.0) | 0.5 (0.3) | 0.5 (0.5) | 0.0 (0.3) | 0.0 (−0.1 to 0.0) | 0.06 |
| Physiotherapists | 0.1 (0.1) | 0.1 (0.0) | 0.0 (0.0) | 0.1 (0.0) | 0.1 (0.0) | 0.0 (0.0) | 0.0 (0.0 to 0.0) | 0.20 |
| Psychologists | 0.0 (0.0) | 0.0 (0.0) | 0.0 (0.0) | 0.0 (0.0) | 0.0 (0.0) | 0.0 (0.0) | 0.0 (0.0 to 0.0) | 0.68 |
| Other | 0.8 (0.0) | 0.8 (0.0) | 0.0 (0.0) | 0.8 (0.0) | 0.8 (0.0) | 0.0 (0.0) | 0.0 (0.0 to 0.1) | 0.78 |
| Total | 17.2 (0.7) | 26.7 (0.9) | 9.5 (0.9) | 18.5 (0.8) | 28.7 (1.1) | 10.2 (0.9) | −0.6 (−3.1 to 1.8) | 0.60 |
| Hospital inpatient (admissions) | ||||||||
| Cardiovascular, acute | 0.6 (0.1) | 0.3 (0.1) | −0.2 (0.1) | 0.6 (0.1) | 0.4 (0.1) | −0.1 (0.1) | −0.1 (−0.3 to 0.1) | 0.27 |
| Cardiovascular, not acute | 0.5 (0.0) | 0.1 (0.0) | −0.4 (0.0) | 0.5 (0.0) | 0.1 (0.0) | −0.4 (0.0) | 0.1 (−0.1 to 0.2) | 0.78 |
| Thoracic surgery acute | 0.1 (0.0) | 0.0 (0.0) | −0.1 (0.0) | 0.1 (0.0) | 0.1 (0.0) | 0.0 (0.0) | −0.1 (−0.1 to 0.0) | 0.22 |
| Thoracic surgery not acute | 1.0 (0.0) | 0.0 (0.0) | −1.0 (0.0) | 1.0 (0.0) | 0.0 (0.0) | −1.0 (0.0) | 0.0 (−0.1 to 0.1) | 0.71 |
| Other, acute | 1.1 (0.1) | 0.7 (0.1) | −0.4 (0.1) | 1.4 (0.1) | 1.0 (0.1) | −0.4 (0.2) | −0.1 (−0.4 to 0.3) | 0.69 |
| Other, not acute | 0.4 (0.0) | 0.2 (0.0) | −0.1 (0.1) | 0.3 (0.0) | 0.2 (0.0) | −0.2 (0.1) | 0.1 (−0.1 to 0.2) | 0.26 |
| Total | 3.6 (0.1) | 1.4 (0.1) | −2.2 (0.1) | 4.0 (0.2) | 1.8 (0.2) | −2.2 (0.2) | −0.1 (−0.6 to 0.4) | 0.80 |
| Bed days | 21.9 (1.1) | 5.9 (0.8) | −15.9 (1.1) | 24.3 (1.5) | 7.2 (1.0) | −17.1 (1.7) | 1.2 (−2.9 to 5.2) | 0.57 |
| Hospital outpatient (visits) | ||||||||
| Cardiology | 3.0 (0.2) | 5.3 (0.6) | 2.4 (0.6) | 2.5 (0.2) | 3.8 (0.5) | 1.3 (0.5) | 1.0 (−0.5 to 2.6) | 0.19 |
| Thoracic surgery | 0.2 (0.1) | 1.3 (0.2) | 1.1 (0.2) | 0.3 (0.0) | 0.7 (0.1) | 0.3 (0.1) | 0.8 (0.3 to 1.3) | <0.01 |
| Other | 6.7 (0.7) | 12.6 (0.9) | 6.0 (0.7) | 6.0 (0.4) | 8.2 (0.9) | 2.2 (0.8) | 3.8 (1.6 to 5.9) | <0.01 |
| Total | 9.9 (0.8) | 19.3 (1.0) | 9.4 (0.9) | 8.8 (0.5) | 12.7 (1.1) | 3.9 (1.0) | 5.6 (2.9 to 8.3) | <0.01 |
| Prescription medication (DDD) | ||||||||
| Ace-inhibitors | 145.6 (17.9) | 248.9 (25.2) | 103.3 (22.2) | 148.1 (19.5) | 222.9 (25.8) | 74.8 (22.6) | 28.4 (−31.7 to 88.6) | 0.35 |
| Antithrombotic | 175.2 (12.0) | 267.8 (14.2) | 92.6 (14.8) | 158.9 (13.2) | 263.9 (14.0) | 105.0 (16.4) | −12.4 (−55.7 to 31.0) | 0.58 |
| β-blockers | 51.7 (5.5) | 132.2 (8.1) | 80.5 (7.8) | 53.4 (6.2) | 113.7 (8.9) | 60.3 (8.0) | 20.2 (−1.6 to 42.1) | 0.08 |
| Spironolactone | 6.5 (1.9) | 14.7 (2.7) | 8.2 (2.5) | 8.3 (2.1) | 17.9 (3.4) | 9.6 (3.4) | −1.4 (−9.4 to 6.8) | 0.74 |
| Lipid modifying | 62.4 (13.5) | 115.9 (18.8) | 53.5 (13.6) | 59.3 (16.7) | 118.7 (24.9) | 59.4 (18.6) | −5.9 (−50.4 to 38.7) | 0.79 |
| Digoxin | 12.5 (3.7) | 16.2 (3.5) | 3.6 (4.6) | 11.4 (3.5) | 18.8 (3.9) | 7.3 (3.8) | −3.7 (−15.5 to 8.0) | 0.54 |
| Diuretics | 271.2 (62.1) | 350.8 (37.8) | 79.5 (66.0) | 219.3 (51.9) | 344.8 (30.8) | 125.5 (52.0) | −46.0 (−211.2 to 119.3) 0.58 | 0.58 |
| Vitamin K antagonists | 31.8 (4.1) | 124.8 (8.7) | 93.0 (8.7) | 34.2 (5.1) | 112.0 (8.8) | 77.8 (8.8) | 15.2 (−9.1 to 39.6) | 0.22 |
| Psycholeptics | 0.5 (0.5) | 0.5 (0.5) | 0.00 (0.0) | 1.8 (0.9) | 1.8 (0.9) | 0.0 (0.0) | 0.0 (−2.5 to 2.5) | 1.00 |
| Antiarrythmics | 7.1 (2.0) | 33.5 (5.0) | 26.3 (4.7) | 9.1 (1.1) | 26.7 (5.2) | 17.6 (5.6) | 8.7 (−5.8 to 23.2) | 0.24 |
| Analgetics* | 32.6 (5.4) | 46.6 (6.2) | 14.4 (3.0) | 47.2 (7.8) | 67.0 (8.5) | 19.9 (5.6) | −5.4 (−18.0 to 7.2) | 0.39 |
| Other cardiovascular | 238.5 (20.8) | 254.2 (21.9) | 15.7 (22.8) | 238.8 (25.4) | 241.2 (22.8) | 2.3 (21.4) | 13.4 (−47.5 to 74.3) | 0.67 |
| Other medication | 553.4 (32.8) | 704.2 (33.0) | 150.8 (23.2) | 609.1 (40.9) | 817.5 (47.4) | 208.4 (27.8) | −57.6 (−128.1 to 12.9) | 0.11 |
| Total | 1588.6 (99.9) | 2310.3 (80.2) | 721.7 (96.6) | 1599.0 (100.0) | 2367.0 (93.2) | 768.0 (78.2) | −46.2 (−287.2 to 195.5) | 0.71 |
| Sick leave (weeks) | 1.4 (0.3) | 4.8 (0.7) | 3.4 (0.6) | 1.2 (0.3) | 3.5 (0.7) | 2.4 (0.5) | 1.0 (−0.6 to 2.7) | 0.21 |
Values are mean number of visits/amounts and associated SE 1 year presurgery and postsurgery.
*Includes analgetics and topical products with DDD value for joint and muscular pain.
CR, cardiac rehabilitation, DDD, defined daily doses.