Cost-effectiveness of cardiac rehabilitation after myocardial infarction

J Cardiopulm Rehabil. 1997 Jul-Aug;17(4):222-31. doi: 10.1097/00008483-199707000-00002.


Background: Cardiac rehabilitation is commonly prescribed after myocardial infarction (MI) to coordinate exercise training and secondary preventive services. Cost-effectiveness analysis allows the quantitative comparison of the relative economic worth of cardiac rehabilitation in relation to other common interventions.

Methods: The cost-effectiveness of cardiac rehabilitation, in dollars per year of life saved ($/YLS), was calculated by combining published results of randomized trials of cardiac rehabilitation on mortality rates, epidemiologic studies of long-term survival in the overall postinfarction population, and studies of patient charges for rehabilitation services and averted medical expenses for hospitalizations after rehabilitation.

Results: Cardiac rehabilitation participants experienced an incremental life expectancy of 0.202 years during a 15-year period. In 1988, the average cost of rehabilitation and exercise testing was $1,485, partially offset by averted cardiac rehospitalizations of $850 per patient. A cost-effectiveness value of 2,130 $/YLS was determined for the late 1980s, projected to a value of 4,950 $/YLS for 1995. A sensitivity analysis supports the study results.

Conclusions: Compared with other post-MI treatment interventions, cardiac rehabilitation is more cost-effective than thrombolytic therapy, coronary bypass surgery, and cholesterol lowering drugs, though less cost-effective than smoking cessation programs. Cardiac rehabilitation should stand alongside these therapies as standard of care in the post-MI setting.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cost Savings
  • Cost-Benefit Analysis
  • Exercise Therapy / economics*
  • Exercise Therapy / standards
  • Humans
  • Life Expectancy
  • Myocardial Infarction / economics
  • Myocardial Infarction / rehabilitation*
  • Patient Readmission / economics
  • Sensitivity and Specificity
  • Survival Analysis
  • Treatment Outcome
  • Value of Life