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  • Karam I Turk-Adawi
  • Marta Supervia
  • Francisco Lopez-Jimenez
  • Ella Pesah
  • D Rongjing
  • Raquel Britto
  • Birna Bjarnason-Wehrens
  • Wayne Derman
  • Ana Abreu
  • Sherry L Grace



WCC 2018 Abstract SubmissionEpidemiology / Prevention / Health Promotion / Physical Activity / AdvocacyWCC2018-ABS-1254CARDIAC REHABILITATION AVAILABILITY AND DENSITY AROUND THE GLOBEKaram Turk-Adawi*1, Marta Supervia2,3, Francisco Lopez-Jimenez2, Ella Pesah4, Rongjing Ding5, Raquel Britto6, Birna Bjarnason-Wehrens7, Wayne Derman8, Ana Abreu9, Sherry L. Grace4,101Public Health, Qatar University, Doha, Qatar, 2Mayo Clinic , Rochester, United States, 3Gregorio Marañón General University Hospital, Gregorio Marañón Health Research Institute, Madrid, Spain, 4School of Kinesiology and Health Science, York University, Toronto, Canada, 5Peiking University People' Hospital, Beijing Shi, China, 6Universidade Federal de MInas Gerais, Belo Horizonte , Brazil, 7Deutsche Sporthochschule Köln, Köln, Germany, 8Stellenbosch University & International Olympic Committee Research Center, Stellenbosch, South Africa, 9Hospital Santa Marta, Lisbon, Portugal, 10University Health Network, Toronto, CanadaIntroduction:Despite the global epidemic of cardiovascular disease and the proven benefits of cardiac rehabilitation (CR), program availability and capacity have never been characterized around theworld.Objectives:to establish CR availability, volumes and its’ drivers, density, and delivery barriers.Methods:Availability of any CR in every country of the world was identified via theliterature, and cardiac associations were consulted to confirm. Champions from each country with CR were enlisted to identify the number of programs and to administer them an online survey, which assessed volumes and capacity. Factors associated with volumes were assessedusing generalized linear mixed models, and compared by World Health Organization region. Density was computed using Global Burden of Disease study ischemic heart disease (IHD) estimates.Results:CR was available in 111/203 (54.7%) countries; data were collected in 93 (83.8%; N=1,082 surveys, 32.1% program response rate). Availability by region ranged from 85.2% of countries in Europe, to 17.0% in Africa (p<·001). There were 3,373 programs in the world that could serve 1,675,270 patients/year, despite an estimated 20,611,675 incident IHD cases globally/year. Where available, the median CR volumewas 157 patients/program annually (interquartile range=75-350); volume was significantly greater where patients were systematically referred (OR=1.35, 95% CI 1.35-1.38) and programs offered alternative models (OR=1.05, 95% CI 1.04-1.06), and significantly lower with private or public funding (OR= 0.92, 95% CI 0.91-0.93 and OR=0.83, 95% CI 0.82-0.84) compared to hybrid sources, among others.Median capacity was 0 patients/country globally. The CR density was one CR spot per 11 IHD cases in countries with CR, and 12 globally. Financial resources were the greatest barrier.Conclusion:CR is available in only half of countries globally. Where offered, capacity is grossly insufficient to serve patients in need, such that most indicated patients will not derive the benefits associated with participation.Disclosure of Interest: None Declared
ZeitschriftGlobal Health Promotion
PublikationsstatusVeröffentlicht - 26.09.2018

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WCC 2018

ID: 3665363

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