CARDIAC REHABILITATION PROGRAMS - PRESENT SITUATION AND PROJECTION FOR 2010 - AN INQUIRY IN THE CANTON-OF-VAUD

Compared to the situation in other European countries and the United S tates, Switzerland chiefly offers inpatient cardiac rehabilitation pro grammes (CRP). In the opinion of specialists and medical literature, w e can expect an increased number of patients with cardiovascular disea ses in the next 15 years, as well as a widening of indications for CRP among older patients and those with advanced cardiac conditions. We c onducted an inquiry among professionals practising or prescribing CRP in order to estimate population needs and coverage for CRP and to iden tify the factors that will determine its future. Based on various sour ces of information, we estimated the incidence of coronary events and demand for CRP in the Canton of Vaud. Cardiac rehabilitation centers p rovided their occupation statistics for 1993. Simultations were carrie d out based on the opinion of specialists and expected demographic tre nds for the next 15 years. In recent years, 600 to 700 patients have b een annually enrolled in CRP. Among patients admitted to acute care ho spitals after myocardial infarction, 65% of those under 65 years of ag e and 14% of those between 65 and 74 entered CRP programmes. Most of t hem followed inpatient programmes in two private clinics which current ly cover CRP needs with a capacity of 1500 patients a year. If we expe ct a 20% increase in the rate of coronary events over the next 15 year s, due to demographic trends, without a change in the incidence of cor onary disease, the present resources in residential CRP will remain su fficient. However, we can expect that part of the patient surplus will enter outpatient CRP programmes.