[Ambulatory phase II rehabilitation of heart patients in the Rhine-Main district hospital: the Frankfurt model].

In the early 90s the German approach to phase II cardiac rehabilitation differed markedly from that which was usually practiced in the anglosaxon countries, as it covered almost exclusively a 4-week comprehensive, residential program far away from home in an often idyllic spa. However as many as approximately 60% of the cardiac patients did not take advantage of this offer, mainly because they felt separated from their families in residential programs. Therefore, because of good experiences with outpatient programs in other countries and in order to minimize costs, the so-called Frankfurt model, an outpatient phase II rehabilitation program, was performed at the University hospital in Frankfurt. The aim of this innovative program was to find out, whether it was as effective as the German "gold standard" of residential rehabilitation and whether is was practicable at a hospital. The program was carried out in a pilot phase over 1 year according to the standards of comprehensive cardiac rehabilitation in 41 patients, who had a follow-up examination 6 months later. The outcomes were compared with results of residential programs, which, however, were not collected in a controlled way. The short- and medium-term results concerning somatic outcomes, e.g. the risk factor profile or the improvement of the maximum work capacity, were equal to the residential programs. The percentage and timing of return-to-work, however, was much higher in the outpatient program obviously due to selection phenomena. The rehabilitation program at the hospital was practicable and safe. Under given conditions and meeting the standards for comprehensive cardiac rehabilitation an outpatient phase II rehabilitation program is practicable and safe with good short- and medium-term results also at a hospital. Such a program offers a good alternative to patients who do not want to rehabilitate under strictly residential conditions far away from home.