Outpatient cardiac rehabilitation part VII: Economic Evaluation

In addition to the results of the prospective multicentre cohort study on the effectiveness of the outpatient cardiac phase III rehabilitation programme (see part VI of the project), the aim of this report was to compare the costs that occur due to the treatment of cardiovascular diseases of patients who underwent an outpatient cardiac phase III rehabilitation programme (intervention group, IG) and patients who did not receive phase III and therefore exclusively completed phase II (control group, CG). The costs were calculated for a time horizon of 18 months (1.5 years) after the end of the phase II rehabilitation, taking into account the costs for public reimbursement authorities in the health care system. The data of a total of 164 patients was analysed for this report. Of these, 78 were in the intervention group and 86 in the control group. The average observation period was around 16 months. The average costs for the phase III rehabilitation were 2,457 euros per patient (of the IG). The average costs per patient for re-rehabilitations (IG 185 euros; CG 491 euros), physician visits (IG 128 euros; CG 174 euros) and non-cardiovascular drugs (IG 159 euros; CG 175 euros) were lower in the intervention group. However, for examinations (IG 381 euros; CG 339 euros), for physiotherapy (48 euros in the IG and 45 euros in the CG), for cardiovascular drugs (IG 528 euros; CG 481 euros) and for treatment in hospitals (1,213 euros in the IG und 1,196 euros in the CG) the costs were higher in the intervention group. The total costs that occurred for patients in the control groups (after the phase II cardiac rehabilitation) were 2,900 euros per patient on average. The total costs after the phase II rehabilitation were 5,099 euros per patient in the intervention groups. However, this amount includes also the additional costs of the phase III rehabilitation. Under the given assumptions, the costs of the phase III rehabilitation exceed potential cost savings (e.g. for re-rehabilitations or physician visits).