Resultado clínico e econômico de um programa de reabilitação cardiopulmonar e metabólica

2007 Arquivos Brasileiros de Cardiologia  
We congratulate the authors for the publication of another study, which demonstrates the importance of the cardiopulmonary and metabolic rehabilitation program (CPMR) (Arq Bras Cardiol. 2007;88(3):321-8) in clinical practice. Previous studies have shown a significant morbimortality decrease and quality of life improvement in patients who participated in a rehabilitation program 1,2 . However, the cost/effectiveness ratio has not been analyzed in Brazil. We, therefore, stress the importance of
more » ... rforming a prospective study that demonstrates the real economical benefits in the treatment of patients. The study design evaluated the clinical result, but the reports and medical files of the control group were not used. A prospective study with a control group would allow increased data reliability, describing the actual course of the patients. The pairing of the groups attained a homogeneous sample regarding the clinical and demographic criteria. However, regarding the cost variable, it presented an elevated standard deviation and additionally, the control group (CG) at the moment of the pre-implementation of the CPMR program showed higher expenses when compared to the treatment group (TG). The results present significant differences in the plasma lipoprotein profile, in the systemic arterial pressure and in tolerance to physical stress when the CPMR pre-and post-implementation moments were compared. Regarding the economical results, the TG presented a tendency to decrease expenses whereas the CG presented a tendency to increase them. Nevertheless, to our surprise, the data were not statistically significant. Scientific studies carried out in developed countries have shown significant results regarding the economical factor after the implementation of a CPMR program 3 . An alternative to try to demonstrate a significant difference in the present study would be the pairing of the groups in relation to the pre-intervention costs. The cost/effectiveness ratio is defined as the difference between the costs of two interventions, divided by the difference between their effectiveness, e.g., the years of life saved in a certain population adjusted by the quality of life presented by it 4 . Georgiou et al 5 observed an excellent cost/effectiveness ratio with an increase in life expectancy of 1.82 year at a cost of U$1,773 per life saved. In the present study, the cost of R$ 270.00 established for the expenses with the CPMR program can be considered much more favorable regarding the cost-effectiveness, when compared to other studies. In any case, the present study presents a relevant and very often overlooked issue. It will certainly become a reference for further investigation studies of cost/effectiveness and clinical benefits for the implementation of this type of assistance to the population.
doi:10.1590/s0066-782x2007001600011 fatcat:eeqlltrayzbh7khl6obiiozxcy