{"title":"Effect of cardiac rehabilitation on progression to long-term care: A clinical and economic longitudinal study in Japan.","authors":"Tomoyuki Takura, Arihiro Kiyosue, Teruyuki Koyama, Mitsuo Takei, Asao Honda","doi":"10.1016/j.jjcc.2025.01.005","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The social burden of nursing care is increasing with age, particularly for patients with heart failure who often require intensive care. This study aimed to clarify the relationship between nursing care needs and the clinical status of patients with a history of cardiovascular disease, focusing on the benefits of cardiac rehabilitation (CR) in reducing these needs.</p><p><strong>Methods: </strong>This single-gate, multicenter, retrospective observational study included patients of all ages with a history of hospitalization for cardiovascular diseases using government-administered insurance claims and health examination data. Data spanning a four-year period (April 2014 to March 2018) were analyzed, and the effects of CR on nursing care needs and associated factors were examined. Multivariate analysis and propensity score matching were used to adjust for confounding factors, ensuring a robust comparison between CR and non-CR groups.</p><p><strong>Results: </strong>A total of 48,456 patients were enrolled, with an average follow-up of 36.1 months. After propensity score matching, patients who participated in CR demonstrated significantly lower mortality rates and reduced nursing care needs compared to those who did not (0.02 ± 0.13 vs. 0.04 ± 0.20, p < 0.01, 0.94 ± 0.27 vs. base: 1, p = 0.05). CR was associated with improved adherence to medications and increased generic drug prescriptions, contributing to better long-term health outcomes. The adjusted odds ratio for CR in reducing nursing care needs was 0.574 (95 % CI, 0.347-0.948, p < 0.05).</p><p><strong>Conclusions: </strong>This study confirms the potential critical role of CR in reducing mortality and nursing care needs in patients with cardiovascular disease. Although CR did not directly reduce nursing care costs, it contributed to improved health outcomes and reduced dependency on long-term care services. These findings highlight the benefits of CR as a preventive intervention, especially in aging populations. Further research is needed regarding its long-term economic benefits.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5000,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of cardiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jjcc.2025.01.005","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Background: The social burden of nursing care is increasing with age, particularly for patients with heart failure who often require intensive care. This study aimed to clarify the relationship between nursing care needs and the clinical status of patients with a history of cardiovascular disease, focusing on the benefits of cardiac rehabilitation (CR) in reducing these needs.
Methods: This single-gate, multicenter, retrospective observational study included patients of all ages with a history of hospitalization for cardiovascular diseases using government-administered insurance claims and health examination data. Data spanning a four-year period (April 2014 to March 2018) were analyzed, and the effects of CR on nursing care needs and associated factors were examined. Multivariate analysis and propensity score matching were used to adjust for confounding factors, ensuring a robust comparison between CR and non-CR groups.
Results: A total of 48,456 patients were enrolled, with an average follow-up of 36.1 months. After propensity score matching, patients who participated in CR demonstrated significantly lower mortality rates and reduced nursing care needs compared to those who did not (0.02 ± 0.13 vs. 0.04 ± 0.20, p < 0.01, 0.94 ± 0.27 vs. base: 1, p = 0.05). CR was associated with improved adherence to medications and increased generic drug prescriptions, contributing to better long-term health outcomes. The adjusted odds ratio for CR in reducing nursing care needs was 0.574 (95 % CI, 0.347-0.948, p < 0.05).
Conclusions: This study confirms the potential critical role of CR in reducing mortality and nursing care needs in patients with cardiovascular disease. Although CR did not directly reduce nursing care costs, it contributed to improved health outcomes and reduced dependency on long-term care services. These findings highlight the benefits of CR as a preventive intervention, especially in aging populations. Further research is needed regarding its long-term economic benefits.
期刊介绍：
The official journal of the Japanese College of Cardiology is an international, English language, peer-reviewed journal publishing the latest findings in cardiovascular medicine. Journal of Cardiology (JC) aims to publish the highest-quality material covering original basic and clinical research on all aspects of cardiovascular disease. Topics covered include ischemic heart disease, cardiomyopathy, valvular heart disease, vascular disease, hypertension, arrhythmia, congenital heart disease, pharmacological and non-pharmacological treatment, new diagnostic techniques, and cardiovascular imaging. JC also publishes a selection of review articles, clinical trials, short communications, and important messages and letters to the editor.
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