The long-term improvement of risk-factors for cardiovascular diseases by residential rehabilitation – results of a three-years-period – calculation of the economical benefit

About 3 years after discharge from residential rehabilitation, in patients affected with cardiovascular risk factors the average reduction in blood pressure is 20 mmHg for systolic, and 10 mmHg for diastolic values. The part of the manifestly hypertensive patients is long term reduced by about 50 %. The part of the patients with pathologically high lipid serum levels is also long-term reduced by about 50 % (for example reduction of cholesterin levels by 14 % or 35 mg/dl, reduction of LDL levels by 20 % or 40 mg/dl, reduction of the cholesterin-HDL-quotient by 18 % or 1,0). A long term improvement of pathological increases in body weight is achievable in 95 % of the patients; the mean reduction of body weight is 3,4 kg. The part of the obese patients (exceeding the “Broca” normal weight by more than 20 %) is long-term reduced by 22 %; a long term complete normalization of body weight is achievable in 22 % of the patients.

Based on these significant results, and based on puplished intervention trails, epidemiological and economical dates, the cost benefit of residential rehabilitation was calculated with regard to the 80 million population of the German Republic. According to published epidemiologic and econimic data from several authors, the calculations were based on the following basal parameters refered to Germany:

  - average individual cost of a three-week residential rehabilitation care: EUR 1700,00 per head
  - total individual costs of cardiovascular diseases (56 % direct and 44 % indirect costs) per annum and per head: EUR 3100,00
  - total popular costs of cardiovascular diseases (direct and indirect costs) per annum: EUR 15 milliards
  - total costs of drugs in cardiovascular diseases per annum: EUR 5 millards (30,7 % of all drugs)
  - total costs of antihypertensive drugs per annum: EUR 2,5 milliards (15,4 % of all drugs)
  - total costs of hospital treatments associated with cardiovascular diseases per annum: EUR 9 milliards (18 % of all hospital costs)
  - total costs of treatments associated with obesity per annum: EUR 250 milliards (6 % of all treatment costs)
  - number of patients with coronary heart disease in Germany: 2,5 millions
  - number of patients with cerebrovascular diseases in Germany: 6,0 millions
  - number of patients with acute myocardial infarctions per annum: 282 000
  - number of patients with acute stroke per annum: 175 000
  - number of hospital treatments associated with cardiovascular diseases per annum: 2,4 millions (16 % of all hospital cases).

Based on published results of several intervention studies and associated with the long-term reductions of cardiovascular risk factors,  reductions of incidences for cardiovascular diseases achievable by a three-week residential rehabilitation can be estimated as follows:

  - for all patients with hypertension: about minus 35 % (minus 32 % for myocardial infarctions, minus 36 % for strokes)
  - for all patients with dyslipidemia: about minus 17 %
  - for all patients with obesity: about minus 11 %
  - for all rehabilitation patients: about minus 21 % (average value).

A three week rehabilitation will be amortized, if the incidence of cardiovascular complications is long term reduced by 18 %. The incidence of these complications will be reduced by 35 % in cases of hypertension, by 17 % in cases of dyslipidemia, by 11 % in cases of obesity. The average reduction of the incidence of cardiovascular complications for all cases will be about 21 % as mentioned above.

Further amortisations can be calculated based on the delay of the manifestations of cardiovascular complications. Thus, after the period of rehabilitation, a three week rehabilitation will be amortized, when the manifestation of cardiovascular complications is delayed by 0,56 years in cases of hypertension, by 1,2 years in cases of dyslipidemia and by 2,5 years in cases of obesity. Further cost benefits can be expected as a long term improvement of pathological increases in body weight produces positive influences on several other diseases, correlated with obesity (e.g. cancer, arthrosis and intervertebral disk degenerations).

Publication:

Piper, J.:
The long-term improvement of risk factors for cardiovascular diseases by inpatient rehabilitation.
- results of a three-years-period-calculation of the economical benefit (in German)
Praev.-Rehab., 12 / 1, 31-44, Dustri, 2000

Copyright: Joerg Piper, Bad Bertrich, Germany, 2007

[Introduction]
[Luminance Contrast]
[Relief Phase Contrast]
[Digital Photomicrography and Analysis]
[Cytometry in Reflexion Contrast]
[Capillaroscopy]
[Video-Endoscopy]
[Calculation of Cardiovascular Risk]
[Behavioral Risk Management]
[Efficiency in Rehabilitation]
[Diagnostics in Rehabilitation]
[Complementary Medicine]
[Publications]
[Curriculum vitae]
[University of Oradea]