[Outcome based center comparisons in inpatient cardiac rehabilitation - results from the EVA-Reha® Cardiology project].

BACKGROUND

So far, for center comparisons in inpatient cardiac rehabilitation (CR), the objective outcome quality was neglected because of challenges in quantifying the overall success of CR. In this article, a multifactorial benchmark model measuring the individual rehabilitation success is presented.

METHODS

In 21 rehabilitation centers, 5123 patients were consecutively enrolled between 01/2010 and 12/2012 in the prospective multicenter registry EVA-Reha (®) Cardiology. Changes in 13 indicators in the areas cardiovascular risk factors, physical performance and subjective health during rehabilitation were evaluated according to levels of severity. Changes were only rated for patients who needed a medical intervention. Additionally, the changes had to be clinically relevant. Therefore Minimal Important Differences (MID) were predefined. Ratings were combined to a single score, the multiple outcome criterion (MEK).

RESULTS

The MEK was determined for all patients (71.7 ± 7.4 years, 76.9% men) and consisted of an average of 5.6 indicators. After risk adjustment for sociodemographic and clinical baseline parameters, MEK was used for center ranking. In addition, individual results of indicators were compared with means of all study sites.

CONCLUSION

With the method presented here, the outcome quality can be quantified and outcome-based comparisons of providers can be made.