Access to Decide on a Generalization: Results From the EVA-Corse Experiment: Efficiency and Clinical Non-Inferiority of a Hybrid Cardiac Rehabilitation Model in Corsica
Author(s)
Camille Nevoret, PhD1, Antoine Faure, MD2, Igor Giusti, PhD3, Stephane Bouee, MD1, Frédéric Bousquet, PhD4, Annie Fouard, MD5, Laura Bezannier, MSc1, Corinne Emery, MSc1, Valérie Donio, MSc1.
1CEMKA, Bourg-la-Reine, France, 2CH de Bastia, Bastia, France, 3Fédération Corse pour la Coordination et l'Innovation en Santé (FCCIS),, Bastia, France, 4CNAM, Paris, France, 5Equipe Nationale, Ministère de la Santé, Paris, France.
1CEMKA, Bourg-la-Reine, France, 2CH de Bastia, Bastia, France, 3Fédération Corse pour la Coordination et l'Innovation en Santé (FCCIS),, Bastia, France, 4CNAM, Paris, France, 5Equipe Nationale, Ministère de la Santé, Paris, France.
OBJECTIVES: To evaluate the clinical non-inferiority and efficiency of EVA-Corse: a hybrid cardiac rehabilitation (CR) model combining hospital-based and community-based care in Corsica. EVA-Corse is an experiment financed by the French health system innovation fund (named Article51).
METHODS: A comparative study was conducted using data from the French National Health Data System (SNDS) linked to data from clinical information system. The intervention group (n=305) received the EVA-Corse program, while the control group (n=274) underwent traditional hospital-based CR. Healthcare consumption and costs were analysed during the rehabilitation period and 6 months post-intervention. Clinical outcomes were assessed using metabolic equivalent (MET) scores.
RESULTS: Clinically, EVA-Corse achieved its objective of non-inferiority compared to total SMR care, with a 16.6% increase in MET scores for the EVA-Corse group vs 11% in the control group (p=0.0198). The EVA-Corse group also demonstrated increased VO2 max. Both groups showed similar progress in physical activity, cardiovascular risk reduction (Interheart score), Mediterranean diet adherence, and overall well-being improvement. During the rehabilitation period, the EVA-Corse group had significantly lower total healthcare expenditures (4,514€ vs 7,083€, p<0.001), primarily due to reduced hospital costs (1,330€ vs 5,042€, p<0.001). This cost difference remained favourable to EVA-Corse even after including the program's forfeit cost (1,610€ per patient).
CONCLUSIONS: The EVA-Corse hybrid CR significantly reduces healthcare costs during the rehabilitation period while maintaining clinical efficacy, suggesting a viable alternative for expanding CR access in remote areas. EVA-Corse will contribute to the definition of new methods of organizing hybrid and local CR.
METHODS: A comparative study was conducted using data from the French National Health Data System (SNDS) linked to data from clinical information system. The intervention group (n=305) received the EVA-Corse program, while the control group (n=274) underwent traditional hospital-based CR. Healthcare consumption and costs were analysed during the rehabilitation period and 6 months post-intervention. Clinical outcomes were assessed using metabolic equivalent (MET) scores.
RESULTS: Clinically, EVA-Corse achieved its objective of non-inferiority compared to total SMR care, with a 16.6% increase in MET scores for the EVA-Corse group vs 11% in the control group (p=0.0198). The EVA-Corse group also demonstrated increased VO2 max. Both groups showed similar progress in physical activity, cardiovascular risk reduction (Interheart score), Mediterranean diet adherence, and overall well-being improvement. During the rehabilitation period, the EVA-Corse group had significantly lower total healthcare expenditures (4,514€ vs 7,083€, p<0.001), primarily due to reduced hospital costs (1,330€ vs 5,042€, p<0.001). This cost difference remained favourable to EVA-Corse even after including the program's forfeit cost (1,610€ per patient).
CONCLUSIONS: The EVA-Corse hybrid CR significantly reduces healthcare costs during the rehabilitation period while maintaining clinical efficacy, suggesting a viable alternative for expanding CR access in remote areas. EVA-Corse will contribute to the definition of new methods of organizing hybrid and local CR.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
HSD3
Topic
Health Policy & Regulatory, Health Service Delivery & Process of Care, Real World Data & Information Systems
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory)