Why Can’t We Be More like Other Countries?

[D]espite the evidence that cardiac rehabilitation is very effective for patients with coronary heart disease, this latest study shows that services in Europe are much underused, with poor referral and a low participation rateā€¦

  • In France 32.4% of CHD patients were advised to attend rehabilitation, and of those advised 90% attended.
  • In Germany 56.6% were advised, and 91.1% attended.
  • In Italy 51.5% were advised, and 88.7% attended.
  • In the UK 43.0% were advised, and 80.6 attended.
  • In Spain 3% were advised and < 1% attended.

Stone Hearth News (Will this be in the next Commonwealth Fund Press Release?)

Comments (9)

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  1. Cindy says:

    Very interesting, It seems somewhat worse that referrals are low — patients not taking advantage of services were at least advised of them. Wonder why doctors would choose not to refer?

  2. Devon Herrick says:

    Heart disease ranks as the No. 1 killer of people who die from natural causes. I would think that known therapies for this disease would be preached far and wide. It certainly does not make sense that there would be countries like Spain, where only 3% of eligible patients are referred for treatment and less than 1% actually complied.

  3. Brian says:

    Hard to say, Cindy. Maybe some of these countries (like Spain) have a market shortage of rehabilitative services. just guessing

  4. Alex says:

    People are unpredictable. Doctors won’t recommend treatments to patients for a variety of reasons, and patients won’t go for a variety of reasons. It’s probably some combination of these reasons that’s lead to the current situation. I doubt this has an easy explanation to it.

  5. Imrana Iqbal says:

    I wonder, for comparison purposes, what the percentages are for the U.S. I realize though that Americans in general are quite health conscious and that there is growing focus on preventive care and alternative cure methods.

  6. Ambrose Lee says:

    90% attendance = low participation?

  7. brian says:

    It could be that in France, doctors are advising those that they think are most likely to attend.

  8. david says:

    I agree with Ambrose. 90% seems like rather good attendance. I don’t have heart disease, but I don’t even take prescriptions like I’m supposed to 90% of the time.

    And @brian, it certainly could be. What, I wonder would make doctors in France do that? Do medical schools in France teach doctors how to identify patients with more need?

  9. Erika says:

    Government has already inetrvened too much in the health care system so as to make true free-market style competition almost impossible.If we are really going to bring down costs of health care, we need to figure out how to make the patient the consumer, so that the individual consumers of health care are aware of the costs and are discriminating what services they get and where they get them.Under the current system it seems like no one really has an incentive to even figure out the costs.