[Heart rehabilitation. Cost-effectiveness analysis].

OBJECTIVE: Heart rehabilitation programmes improve the quality of life of coronary patients and the prognosis of the illness. Implementing these therapeutic systems into practice would be easier if their economic efficiency was proven. MATERIAL AND METHODS: The expenses created by 180 survivors of a myocardial infarction have been studied at the first and sixth year after the acute episode. The survivors were divided, at random, into two groups of 90. One of them (RG) underwent a rehabilitation programme (physical training, psychological action and control guidelines of risk factors). The other (CG) served as a control. RESULTS: The profits, analyzing the direct expenses (readmissions to hospital) were of 5,074,039 ptas. the first year (CG: 19,901,578; RG: 14,827,539), and of 17,451,910 ptas. at the end of the study (CG: 54,370,249; RG: 36,918,339). Better results were obtained when reviewing the indirect expenses (derived from return to work), since the profits were of 26,000,000 ptas. after the first year (CG: 54,750,000; RG: 28,750,000) and of 209,750,000 at the sixth year (CG: 438,000,000; RG: 228,250,000). The saving per patient was of 272,437 ptas. during the first 12 months and of 2,415,220 at the end of the follow-up. CONCLUSIONS: These results justify the fact that the Public Administration and private Insurance Providers are taking into account the adequacy of implementing these therapeutic systems into practice.