Abstract:
The purpose of this study was to examine the long-term outcomes of adhering to a phase II cardiac rehabilitation program, with regards to cardiovascular-related office visits and expenses. The subjects for the study were cardiac patients who had a history of myocardial infarction or angina and entered Indiana’s Heart Institute phase II cardiac rehabilitation program between January 1, 1989 and June 6, 1992. Only subjects who had a coronary artery bypass graft or percutaneous transluminal coronary angioplasty were included in the study. Each cardiac patient who met the inclusion criteria was classified as either adherer (ADH) or nonadherer (NON). Patients were judged to be adherers if they attended all 36 of the scheduled exercise sessions. A nonadherer, was defined as an individual who stopped attending the program and participated in eight or less of the scheduled sessions. The nonaderence group consisted of 29 patients and adherence group consisted of 42 patients. The patients exercised for 45 minutes, three days per week, and attended education classes. Education classes covered topics on diet, exercise, stress, smoking cessation, plus other modifiable behavior topics that relate to cardiac risk factors. Insurance billing records for each subject was examined over a 5 year follow-up period. Medical usage information, in terms of cardiovascular-related office visits and expenses, were then compared between adherence and nonadherence groups. The average amount of cardiovascular related doctor visits was 5.2+/- 4.6 visits within 5 years and 4 months after they initially started phase II cardiac rehabilitation. Overall, the total dollar amount spent on cardiovascular doctor visits and expenses was $2710 +/-$2301. The nonadherence group (6.5 +/- 5.4) had significantly (p<.05) more cardiovascular-related medical expenses was found to be much higher in the nonadherence group ($3324 +/- 2475) compared to the adherence group ($2283 + 2096), the difference was not large enough to be statistically significant. It was concluded that adherence to a phase II cardiac rehabilitation program would positively influence cardiac patients future amount of medical usage.