Abstract
Although the rate of retirement after coronary bypass surgery seems to vary in different countries between some 60% and 25% (Niles et al. 1980; Walter et al. 1983; Yacoub and Guvendik 1984; Sergeant et al. 1984, this vol p. 108), its tendency to depend upon the state of the economy poses a problem for the definition of rehabilitation. While medical rehabilitation, i.e., the decrease of angina pectoris and the improvement of cardiac function, is reported for the overwhelming majority of CABS patients, return to work, which indicates social rehabilitation, is much less universally achieved; nevertheless, the former is less likely to be accepted as a sufficient criterion for the successful outcome of the operation. The discrepancy between medical and social rehabilitation invites a critical discussion since the long-term cost-effectiveness of the operation as a mode of treating coronary disease is calculated by contrasting the savings in state benefits effected through the patients’ return to work with the cost of unemployment incurred in the case of their retirement (Love 1980). A tacit assumption seems to be made that the high cost of surgery might be somewhat wasted if the operation leads to loss of occupational status which, in turn, necessitates further cost in terms of social security benefits.
Published Version
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