YorkSpace has migrated to a new version of its software. Access our Help Resources to learn how to use the refreshed site. Contact diginit@yorku.ca if you have any questions about the migration.
 

Cardiac rehabilitation availability and delivery in Brazil: a comparison to other upper middle-income countries

Loading...
Thumbnail Image

Date

2020-03

Authors

Grace, Sherry
Herdy, Artur H.
Pereira, Danielle Aparecida Gomes
Jimenez, Francisco Lopez
Pesah, Ella
Chaves, Gabriela Suéllen da Silva
Turk-Adawi, Karam
Supervia, Marta

Journal Title

Journal ISSN

Volume Title

Publisher

Elsevier

Abstract

Background: Brazil has insufficient cardiac rehabilitation (CR) capacity, yet density and regional variation in unmet need is unknown. Moreover, South America has CR guidelines, but whether delivery conforms has not been characterized. This study aimed to establish: (1) CR volumes and density, and (2) the nature of programs, 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 CR programs globally. Cardiac associations were engaged to facilitate program identification. Density was computed using Global Burden of Disease study ischemic heart disease (IHD) incidence estimates. Results were compared to data from the 29 upper-MICs with CR (N=249 programs). Results: CR was available in all 5 regions (only one program in North), with 30/75 programs initiating a survey (40.0% program response rate). There was only one CR spot for every 99 IHD patient. Most programs were funded by government/hospital sources (n=16, 53.3%), but in 11 programs (36.7%) patients depended on private health insurance. Guideline-indicated conditions were accepted in ≥70% of programs. Programs had a team of 3.8±1.9 staff (versus 5.9±2.8 in other upper-MICs, p<0.05), offering 4.0±1.6/10core components (versus 6.0±1.5in 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 CR 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.

Description

Keywords

rehabilitation, availability, health services, upper-middle income country

Citation

Brazilian Journal of Physical Therapy Volume 24, Issue 2, March–April 2020, Pages 167-176