Kinesiology and Health Science, Faculty of Health, York University; KITE-Toronto Rehabilitation Institute and Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada.
Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar.
WHO South East Asia J Public Health. 2021 Jul-Dec;10(2):57-65. doi: 10.4103/WHO-SEAJPH.WHO-SEAJPH_62_21.
The aims of this study were to establish cardiac rehabilitation (CR) availability and density, as well as the nature of programs in South-East Asian Region (SEAR) countries, and to compare this with other regions globally.
In 2016/2017, the International Council of Cardiovascular Prevention and Rehabilitation engaged cardiac associations to facilitate program identification globally. An online survey was administered to identify programs using REDCap, assessing capacity and characteristics. CR density was computed using Global Burden of Disease study annual ischemic heart disease (IHD) incidence estimates. The program audit was updated in 2020.
CR was available in 6/11 (54.5%) SEAR countries. Data were collected in 5 countries (83.3% country response); 32/69 (68.1% response rate from 2016/2017) programs completed the survey. These data were compared to 1082 (32.1%) programs in 93/111 (83.3%) countries with CR. Across SEAR countries, there was only one CR spot per 283 IHD patients (vs. 12 globally), with an unmet regional need of 4,258,968 spots annually. Most programs were in tertiary care centers (n = 25, 78.1%; vs. 46.1% globally, P < 0.001). Most were funded privately (n = 17, 56.7%; vs. 17.9%, P < 0.001), and 22 (73.3%) patients were paying out of pocket (vs. 36.2% globally; P < 0.001). The mean number of staff on the multidisciplinary teams was 5.5 ± 3.0 (vs. 5.9 ± 2.8 globally P = 0.268), offering 8.6 ± 1.7/11 core components (consistent with other countries) over 16.8 ± 12.6 h (vs. 36.2 ± 53.3 globally, P = 0.01).
Funded CR capacity must be augmented in SEAR. Where available, services were consistent with guidelines, and other regions of the globe, despite programs being shorter than other regions.
本研究旨在确定东南亚地区（SEAR）国家心脏康复（CR）的可及性和密度，以及项目的性质，并将其与全球其他地区进行比较。
2016/2017 年，国际心血管预防与康复协会聘请心脏协会在全球范围内协助识别项目。使用 REDCap 进行在线调查，以确定使用情况并评估能力和特征。使用全球疾病负担研究中每年缺血性心脏病（IHD）发病率的估计值计算 CR 密度。2020 年更新了项目审核。
11 个 SEAR 国家中有 6 个（54.5%）提供了 CR。在 5 个国家（83.3%的国家回复率）中收集了数据；2016/2017 年从 69 个（68.1%来自调查的回复率）项目中完成了调查。将这些数据与 111 个（83.3%）有 CR 的国家的 1082 个（32.1%）项目进行了比较。在 SEAR 国家，每 283 名 IHD 患者只有一个 CR 点（全球为 12 个），每年有 4258968 个区域未满足的需求。大多数项目位于三级保健中心（n = 25，78.1%；全球为 46.1%，P < 0.001）。大多数项目由私人资助（n = 17，56.7%；全球为 17.9%，P < 0.001），22 名（73.3%）患者自费（全球为 36.2%；P < 0.001）。多学科团队的平均员工人数为 5.5 ± 3.0（全球为 5.9 ± 2.8，P = 0.268），提供 8.6 ± 1.7/11 项核心内容（与其他国家一致），共 16.8 ± 12.6 小时（全球为 36.2 ± 53.3，P = 0.01）。
SEAR 必须增加资金支持的 CR 能力。在有服务的地方，服务符合指南和全球其他地区的要求，尽管项目时间比其他地区短。
