Maier W, Meier B
Cardiology, University Hospital, Bern, Switzerland.
Eur Heart J. 1998 Nov;19 Suppl O:O24-8.
Exponential evolution of percutaneous, catheter-based revascularization has modified traditional premises of cardiac rehabilitation. With increasing numbers of percutaneous transluminal angioplasty (PTCA) procedures relative to coronary artery bypass grafting interventions, the need for in-patient rehabilitation is declining; on the other hand, the need for life-style counselling within the framework of out-patient rehabilitation is increasing. Risk factor interventions are important to minimize and to retard the progression of the disease. Rehabilitation programmes offer exercise training, stress modification and life style counselling to reduce cardiovascular risk factors and to increase exercise capability. Since costs of out-patient rehabilitation seem to be lower than those of in-patient rehabilitation, a case may be made in favour of directing limited funds to additional interventions and to saving money by replacing in-patient rehabilitation with outpatient programmes after PTCA. The budget-holder has to make the choice.
经皮导管介入血管重建术的迅速发展改变了心脏康复的传统模式。相对于冠状动脉旁路移植术，经皮腔内血管成形术（PTCA）的手术数量不断增加，住院康复的需求正在下降；另一方面，门诊康复框架内生活方式咨询的需求正在增加。危险因素干预对于减少和延缓疾病进展至关重要。康复计划提供运动训练、压力调节和生活方式咨询，以降低心血管危险因素并提高运动能力。由于门诊康复的成本似乎低于住院康复，因此有理由主张将有限的资金用于额外的干预措施，并通过在PTCA后用门诊项目取代住院康复来节省资金。预算管理者必须做出选择。
