Cardiovascular Diseases in Indonesia: Development, Barriers, and Future Challenges of Cardiac Rehabilitation

Vollständiger Abstract

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Introduction: Cardiovascular disease (CVD) remained the leading cause of morbidity and mortality in Indonesia, with a high prevalence posing challenges for medical and rehabilitation management. The unequal distribution of CVD and its risk factors hindered government efforts to allocate healthcare workers, limiting access to cardiac rehabilitation (CR) programs, particularly in underserved areas. Methods: This review analyzed various articles in English and Indonesian, retrieved through Google using relevant keywords, reference exploration, and communication with professional organizations. Results and Discussion: Despite being introduced over 40 years ago, hospital-based CR programs remained scarce, especially in rural regions. Barriers included comorbidities, socioeconomic status, limited accessibility, low referral rates, lack of patient motivation, insurance constraints, insufficient supervised CR facilities, and employment-related issues. Additionally, government challenges in coordination and staffing further restricted CR expansion. However, the high number of CVD patients and individuals at risk presented opportunities for improvement. Strategies such as strengthening referral systems, increasing facilities, regulating healthcare workforce distribution, implementing telerehabilitation, and enhancing government policies on service coverage were crucial to expanding CR access. Conclusion: Although CR in Indonesia has been developed for decades, its availability remains inadequate. Challenges mirrored those of other developing nations, yet the increasing burden of CVD underscored the urgent need to expand CR programs through improved infrastructure, policies, and workforce distribution.