COST-EFFECTIVENESS OF HOME-BASED CARDIAC REHABILITATION. A SYSTEMATIC REVIEW
Author(s)
Noelia Torrejón-Bote, MD.1, Carlos Sanchez-Piedra, PhD.2, Esther-Elena Garcia-Carpintero, PhD.2, Lucía Pedrosa Pérez, PhD.2, Carmen de Pablo-Zarzosa, PhD.3, Mario Pascual-Carrasco, PhD.4, Beatriz León-Salas, PhD.5, Lourdes Rodríguez-Rojas, MD.2, Montserrat Carmona, BSc, MSPH, PhD2.
1Jiménez Díaz Foundation Hospital, Madrid, Spain, 2Instituto de Salud Carlos III- Health Technology Assessment Agency (AETS), Madrid, Spain, 3Sociedad Española de Cardiología, Madrid, Spain, 4e-Health Research Unit. Instituto de Salud Carlos III, Madrid, Spain, 5Servicio de Evaluación del Servicio Canario de Salud, Tenerife, Spain.
1Jiménez Díaz Foundation Hospital, Madrid, Spain, 2Instituto de Salud Carlos III- Health Technology Assessment Agency (AETS), Madrid, Spain, 3Sociedad Española de Cardiología, Madrid, Spain, 4e-Health Research Unit. Instituto de Salud Carlos III, Madrid, Spain, 5Servicio de Evaluación del Servicio Canario de Salud, Tenerife, Spain.
OBJECTIVES: Cardiac rehabilitation (CR) plays a key role among secondary prevention and is recommended for most cardiological diseases due to its functional, psychological, and prognostic benefits. Despite strong evidence supporting its benefits and current clinical practice guideline recommendations, global access to CR remains insufficient, particularly for women, older adults, ethnic minorities, and individuals who are employed and face scheduling incompatibilities. In this context, the need arises to consider the implementation of CR programs in extrahospital settings. Therefore, a systematic review of the current evidence on economic evaluations is proposed. The aim was to analyze the efficiency of home‑based cardiac rehabilitation programs.
METHODS: A systematic search was conducted in databases such as Medline, Cochrane, and Embase, selecting articles that met the inclusion criteria, based on a PICO (Population, Intervention, Comparator and Outcome) research question, in order to evaluate the efficiency of studies implementing some type of home‑based cardiac rehabilitation (HBCR) program. Inclusion criteria comprised comparative analyses of HBCR versus centre-based CR; studies conducted in countries with settings similar to ours; studies in English or Spanish that provided economic evaluations reporting ICER or cost‑utility ratios. Target population: Adults of any sex with an indication for cardiac rehabilitation. Intervention: Home‑based CR delivered through telerehabilitation. Comparator: centre-based CR. Outcomes: Functional capacity, hospital admissions, cardiovascular events, quality of life, costs, incremental cost-utility or cost-effectiveness ratio (ICER or ICUR).
RESULTS: Among the 14 studies included, ICER values ranged from It ranges from being a dominant technology over centre-based CR to achieving an ICUR over 500,000 euros per QALY. However, the overall results show that telerehabilitation is cost‑effective to improve quality of life compared with conventional CR in coronary artery disease and heart failure.
CONCLUSIONS: Telerehabilitation is a viable alternative to standard care, offering comparable effectiveness and generally lower costs.
METHODS: A systematic search was conducted in databases such as Medline, Cochrane, and Embase, selecting articles that met the inclusion criteria, based on a PICO (Population, Intervention, Comparator and Outcome) research question, in order to evaluate the efficiency of studies implementing some type of home‑based cardiac rehabilitation (HBCR) program. Inclusion criteria comprised comparative analyses of HBCR versus centre-based CR; studies conducted in countries with settings similar to ours; studies in English or Spanish that provided economic evaluations reporting ICER or cost‑utility ratios. Target population: Adults of any sex with an indication for cardiac rehabilitation. Intervention: Home‑based CR delivered through telerehabilitation. Comparator: centre-based CR. Outcomes: Functional capacity, hospital admissions, cardiovascular events, quality of life, costs, incremental cost-utility or cost-effectiveness ratio (ICER or ICUR).
RESULTS: Among the 14 studies included, ICER values ranged from It ranges from being a dominant technology over centre-based CR to achieving an ICUR over 500,000 euros per QALY. However, the overall results show that telerehabilitation is cost‑effective to improve quality of life compared with conventional CR in coronary artery disease and heart failure.
CONCLUSIONS: Telerehabilitation is a viable alternative to standard care, offering comparable effectiveness and generally lower costs.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
HTA327
Topic
Economic Evaluation, Health Service Delivery & Process of Care, Health Technology Assessment
Topic Subcategory
Systems & Structure
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory), No Additional Disease & Conditions/Specialized Treatment Areas