• K A Robertson and K Kayhko.
• School of Nursing, University of Prince Edward Island.
• Dynamics. 2001 Jan 1; 12 (4): 25-31.

ObjectiveThe general goal of this research was to determine the effectiveness of a home follow-up program in order to acquire guidance in how to plan the future structure and contents of post-myocardial infarction (MI) patients' care and rehabilitation. The specific aim of this study was to evaluate the cost-effectiveness of the program in reducing the rate of rehospitalization of first-time post-MI patients when measured at six weeks and six months post-discharge.HypothesisThe supportive-educative home follow-up program will prove to be cost-effective by indicating an inverse correlation with the cost of post-MI patients being rehospitalized for unplanned and preventable diagnoses.Design And SettingCost analysis, using data from a one year randomized control clinical trial conducted in a small urban hospital in eastern Canada. An experimental post test only control group design, including the process of randomization, was used in this study.Subjects62 people admitted with a diagnosis of a first-time acute MI during a one-year period with no co-morbidity likely to affect rehabilitation.Main Outcome MeasuresHealth care costs.ResultsEarly supportive home follow-up reduced inpatient rehospitalization by more than half (three rehospitalizations vs seven rehospitalizations) and reduced the average length of stay (five days vs seven days). Cost analysis demonstrated that intense home follow-up in the time immediately following patient discharge could still produce cost savings to the health care system.ConclusionIntensive home follow-up provided a cost-effective alternative to traditional cardiac rehabilitation programs; however, a larger study is required to assess the generalizability of the results and long-term cost effectiveness.

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