Health services savings in patients with cardiac valve replacement after a cardiac rehabilitation program

Introduction/Background In spite of the high prevalence of cardiac valvulopathies, the evidence of the effect of cardiac rehabilitation (CR) after surgical valve replacement (SVR) is scarce, but nevertheless CR is recommended for this group of patients. We aimed to compare the healthcare services utilization when comparing patients after a valve surgery who completed a eight weeks phase II cardiac rehabilitation program to those who did not. Material and method A descriptive retrospective study was conducted of CR eligible patients after SVR aged 18 or older between January 2014 and December 2017 with a follow-up of at least 12 months after surgery. We assessed the number of primary care consultations, emergency service utilization, number of hospital admissions and length of hospital stay because of cardiovascular reasons. Results A total of 124 patients had valve surgery. Fifty-eight (47%) completed CR phases I and II while 66 (53%) patients completed only phase 1 (hospitalization). The mean age was 60.19 years (SD 7.76). The most common type of surgery was aortic replacement (54 = 67.7%). Bioprothesis (24.2%) and mechanical prosthesis (48.4%). Period of follow-up: 33.54 months (SD 10.99). We found participation in phase II CR program is significantly associated with a lower number of visits to the emergency room (25.9% vs. 33.4%, P  > 0.05), less hospitalizations (15.5% vs. 31.8%, P  = 0.016) and shorter length of hospitalization stay (1.33 vs. 4.24 days P  = 0.03). Conclusion Participation in phase I and phase II CR program after SVR significantly reduces healthcare services utilization when compared to those patients who do not attend to a phase II CR program. CR among all these kind of patients is long-term cost-effective so it should be encouraged.