20.500.12556/DiRROS-24560 Uptake and effectiveness of outpatient vs. residential cardiac rehabilitation after myocardial infarction a nationwide analysis Aims: To estimate the participation in, and the comparative effectiveness of, short-term residential and comprehensive outpatient cardiac rehabilitation (CR), after the latter was introduced in Slovenia by establishing dedicated regional CR centers. Methods: We extracted and analyzed data on all patients hospitalized for myocardial infarction in Slovenia (n = 15,639), focusing on CR participation – either comprehensive outpatient (introduced in 2017) or short-term residential (available throughout the study period 2015–2021). Impact on nation-wide CR participation rates was assessed by interrupted time series analysis; impact on patient-level outcomes (all-cause mortality and cardiovascular hospitalizations) was assessed using Kaplan Meier estimators and ‘doubly robust’ Cox regression with propensity score-derived inverse probability of treatment weighting. Results: Of the 11,815 eligible patients (event-free after 180-day landmark), 3819 (32.3%) attended CR. Nation-wide CR participation rates increased both in level (9.7%, 95% CI 6.3–3.1) and in trend (0.41% per month, 95% CI 0.22–0.60) after outpatient CR was introduced in 2017. After propensity score-based adjustment, participation in either CR was associated with lower event rates (12.8%, 17.2%, and 21.0% at 3-year follow-up for outpatient, residential, and no CR, respectively; p < 0.001). Risk reductions were significant for composite outcomes (outpatient: HR 0.58, 95% CI 0.47–0.70; residential: HR 0.79, 95% CI 0.68–0.93) and all-cause mortality (outpatient: HR 0.56, 95% CI 0.38–0.83; residential: HR 0.59, 95% CI 0.45–0.77), whereas the risk reduction for cardiovascular hospitalizations was only significant for outpatient CR (HR 0.60, 95% CI 0.48–0.74). The incremental cost-effectiveness ratio per life-year gained was €6421 and €7381 for outpatient and residential CR, respectively. Conclusions: Participation in either CR improves outcomes after myocardial infarction, but comprehensive outpatient CR conveys superior risk reductions, primarily through reduced cardiovascular hospitalizations. health services diseases rehabilitation social costs zdravstvo bolezni sanacija družbeni stroški true false true Angleški jezik Slovenski jezik Neznano 2025-12-05 14:04:20 2025-12-05 14:04:20 2025-12-06 03:47:56 0000-00-00 00:00:00 2025 0 0 Nasl. z nasl. zaslona; Opis vira z dne 12. 9. 2025; str. 1-18 issue 1 Vol. 20 2025 0000-00-00 Zaloznikova Objavljeno apc 0000-00-00 0000-00-00 0000-00-00 616.1 2211-8179 10.5334/gh.1470 248823811 RAZ_Jug_Borut_2025.pdf RAZ_Jug_Borut_2025.pdf 1 104C59EFB3E530269C95AB75BCC8A292 1fd58994ae44e7372b0c2581b2d26b02dbcef577ca3092e80cc282c8bd5c0a3f 198b9134-d1db-11f0-94a7-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=36636 https://globalheartjournal.com/articles/10.5334/gh.1470 0 289f28d7-d1db-11f0-94a7-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=36637 Univerzitetni klinični center Ljubljana 0 0 0