Hermes Ilarraza-Lomelí1, Marianna García-Saldivia2, Jessica Rojano-Castillo2, Samuel Justiniano3, Norma Cerón4, Zulema-L Aranda-Ayala5, Azucena Rodríguez6, Alejandro Hernández7, María-Elena Cassaigne8, Raúl Cantero9, Pablo Gasca10, Tania Hinojosa11, Jesús Alonso12, Ricardo Romo13, Jorge Lara14, Elizabeth Pimentel15, Juana Zavala16, María-Dolores Rius-Suárez2, Gabriel Cherebetiu17, Othniel Cortés18, Alejandro Almaraz19, Pedro Mendoza20, Jesús Silva21, Enrique Tirado22, Leonel Martínez23. 1. Servicio de Rehabilitación Cardiaca, Instituto Nacional de Cardiología Ignacio Chávez, Mexico. Electronic address: hermes_ilarraza@yahoo.com. 2. Servicio de Rehabilitación Cardiaca, Instituto Nacional de Cardiología Ignacio Chávez, Mexico. 3. Programa Nacional de Rehabilitación Cardiaca, IMSS, Mexico. 4. Rehabilitación Cardiaca, Centro Recovery (Puebla, Pue.), Mexico. 5. Rehabilitación Cardiaca, Cárdica (Cuernavaca, Mor.), Mexico. 6. Rehabilitación Cardiaca, Hospital General Naval de Alta Especialidad, Mexico. 7. Rehabilitación Cardiaca, Instituto Cardiovascular de Saltillo (Saltillo, Coah.), Mexico. 8. Centro de Rehabilitación Cardiopulmonar, Clínica Lomas Altas, Mexico. 9. Rehabilitación Cardiaca, Hospital de Cardiología CMN Siglo XXI-IMSS, Mexico. 10. Rehabilitación Cardiaca, Unidad de Medicina Física y Rehabilitación Centro-IMSS, Mexico. 11. Rehabilitación Cardiaca, Hospital Civil de Guadalajara Dr. Juan I Menchaca (Guadalajara Jal.), Mexico. 12. Rehabilitación Cardiaca, Hospital Bernardette (Guadalajara, Jal.), Mexico. 13. Rehabilitación Cardiaca del Centro (León Gto.), Mexico. 14. Rehabilitación Cardiaca, CARDIOFIT, Mexico. 15. Rehabilitación Cardiaca, Centro Médico "20 de Noviembre"-ISSSTE, Mexico. 16. Rehabilitación Cardiaca, Instituto Nacional de Rehabilitación, Mexico. 17. Fisiología Cardiovascular, RHC y Medicina del Deporte, Hospital Ángeles Pedregal, Mexico. 18. Rehabilitación Cardiaca, Unidad de Medicina Física y Rehabilitación Norte-IMSS, Mexico. 19. Centro de Rehabilitación Cardiaca, Mexico. 20. Rehabilitación Cardiaca, Médica Sur, Mexico. 21. Clínica Médica de Alta Especialidad, Mexico. 22. Rehabilitación Cardiaca, Hospital Tec 100, Mexico. 23. Rehabilitación Cardiaca, PEMEX-Picacho, Mexico.
Abstract
OBJECTIVE: The aim of this paper is to compare the state of Cardiac Rehabilitation Programs (CRP) in 2009 with 2015. Focus is directed on health care, training of health-providers, research, and the barriers to their implementation. METHODS: All authors of RENAPREC-2009, and other cardiac rehabilitation leaders in Mexico were requested to participate. These centres were distributed into two groups: RENAPREC-2009 centres that participated in 2015, and the new CRP units. RESULTS: In 2009 there were 14 centres, two of which disappeared and another two did not respond. CRP-units increased by 71% (n=24), and their geographic distribution shows a centripetal pattern. The coverage of CRP-units was 0.02 centres per 100,000 inhabitants. Only 4.4% of eligible patients were referred to CRP, with a rate of 10.4 patients/100,000 inhabitants in 2015. The ratio of Clinical Cardiologists to Cardiac Rehabilitation Specialists was 94:1, and the ratio of Intervention Specialists to cardiac rehabilitation experts was 16:1. Cardiac rehabilitation activities and costs varied widely. Patient dropout rate in phase II was 12%. Several barriers were identified: financial crisis (83%), lack of skilled personnel (67%), deficient equipment (46%), inadequate areas (42%), and a reduced number of operating centres (38%). CONCLUSIONS: CRPs in Mexico are still in the process of maturing. Mexican CRP-centres have several strengths, like the quality of the education of the professionals and the multidisciplinary programs. However, the lack of referral of patients and the heterogeneity of procedures are still their main weaknesses.
OBJECTIVE: The aim of this paper is to compare the state of Cardiac Rehabilitation Programs (CRP) in 2009 with 2015. Focus is directed on health care, training of health-providers, research, and the barriers to their implementation. METHODS: All authors of RENAPREC-2009, and other cardiac rehabilitation leaders in Mexico were requested to participate. These centres were distributed into two groups: RENAPREC-2009 centres that participated in 2015, and the new CRP units. RESULTS: In 2009 there were 14 centres, two of which disappeared and another two did not respond. CRP-units increased by 71% (n=24), and their geographic distribution shows a centripetal pattern. The coverage of CRP-units was 0.02 centres per 100,000 inhabitants. Only 4.4% of eligible patients were referred to CRP, with a rate of 10.4 patients/100,000 inhabitants in 2015. The ratio of Clinical Cardiologists to Cardiac Rehabilitation Specialists was 94:1, and the ratio of Intervention Specialists to cardiac rehabilitation experts was 16:1. Cardiac rehabilitation activities and costs varied widely. Patient dropout rate in phase II was 12%. Several barriers were identified: financial crisis (83%), lack of skilled personnel (67%), deficient equipment (46%), inadequate areas (42%), and a reduced number of operating centres (38%). CONCLUSIONS: CRPs in Mexico are still in the process of maturing. Mexican CRP-centres have several strengths, like the quality of the education of the professionals and the multidisciplinary programs. However, the lack of referral of patients and the heterogeneity of procedures are still their main weaknesses.
Authors: Carolina Santiago de Araújo Pio; Anna Gagliardi; Neville Suskin; Farah Ahmad; Sherry L Grace Journal: BMC Health Serv Res Date: 2020-08-20 Impact factor: 2.655
Authors: Gabriela Lima de Melo Ghisi; Ella Pesah; Karam Turk-Adawi; Marta Supervia; Francisco Lopez Jimenez; Sherry L Grace Journal: J Clin Med Date: 2018-09-07 Impact factor: 4.241