Overview of Cardiac Rehabilitation in Portugal 2007-2009

Introduction: Cardiovascular disease is the leading cause of death in Europe. Cardiac rehabilitation (CR) has proven benefits, particularly in mortality reduction. Methods: The Portuguese Society of Cardiology's Study Group on Exercise Physiology and Cardiac Rehabilitation has periodically performed surveys of national cardiac rehabilitation centers, the last in 2007. A questionnaire was sent to the various centers requesting general information about the center, staff, program phases and components, type of patients and funding bodies. On the basis of Diagnosis Related Groups (DRGs), the percentage of patients rehabilitated following hospitalization for myocardial infarction was determined. Centers engaged in CR in 2009, subsequent to the 2007 survey, were briefly evaluated. Results: In 2007 there were 16 centers, an increase of 14% compared to 2004. This rose to 18 in 2009, a 13% increase over 2007. The number of rehabilitated cardiac patients in 2007 was more than double that of 2004 - 638 and 312 patients, respectively. Of the rehabilitated patients in 2007, 50% had suffered infarction, similar to the 58% in 2004. Based on DRG data, 3% of patients discharged from hospital after myocardial infarction were admitted to a cardiac rehabilitation program. In 2004, only 1.8% of patients discharged after acute coronary syndrome or CABG underwent cardiac rehabilitation. In 2007, Portugal was second from last in Europe for cardiac rehabilitation. Conclusion: Despite the benefits of cardiac rehabilitation and notwithstanding improvements and growth in the number of centers and patients included in programs, cardiac rehabilitation is still underused in Portugal due to several factors, which have to be overcome.