Return to work guidance within cardiac rehabilitation: content and costs of two settings compared Angelique De Rijk R Drost 1 , C Noben 2 , A Paulus 1 , R Smeets 3 , P Kuijpers 4 , S Evers 1 , A de Rijk 5 1 Health Services, CAPHRI Research, Maastricht University, Maastricht, Netherlands 2 Academie Medische Vervolgopleidingen, Maastricht University Medical Centre +, Maastricht, Netherlands 3 Rehabilitation, CIR, Eindhoven/Zwolle, Netherlands 4 Cardiology, Maastricht University Medical Centre +, Maastricht, Netherlands 5 Social Medicine, CAPHRI, Maastricht University, Maastricht, Netherlands Contact: angelique.derijk@maastrichtuniversity.nl Background: Of those who survived a cardiac event and participated in cardiac rehabilitation (CR), many experience labor participa- tion restrictions. The Dutch CR guideline includes return to work (RTW) guidance but no directives on where CR has to be offered. The aim was to compare rehabilitation centre and hospital based CR regarding 1) how RTW guidance was organised, 2) changes after CR in sickness absence and quality of life, 3) costs. Methods: The study was designed as an exploratory cost-outcome description with naturalistic design. Care was assessed at the level of CR in a specialised rehabilitation centre and a hospital. The study population consisted of 116 employed cardiovas- cular patients (19-63 years of age) of one hospital referred to out-patient level II CR (for complex pathology), either at a rehabilitation centre (n = 53) or at the hospital (n = 63). Information on RTW guidance was obtained by interviews with the CR coordinators. Survey data from patients were collected at baseline, six and twelve months. Results: At baseline, patient groups did not differ apart from sickness absence being higher in the rehabilitation centre group (76 versus 19 days in previous half year). RTW guidance within CR consisted of individual-based therapy including occupational therapy in the rehabilitation centre, and group-based therapy in the hospital. Costs of RTW guidance in the rehabilitation centre were estimated at E1,892.30, versus E296.82 in the hospital (net difference of E1,595.48). Sickness absence increased during CR for the hospital group, and decreased for both groups after twelve months (with 55 and 7 days, respectively); Quality of Life did not change. Conclusions: Costs of CR at the rehabilitation centre were more than six times higher than in the hospital. Patients in the rehabilitation centre might have needed the more intensive RTW guidance. Cost-effectiveness research is needed to confirm if the guide- line should include stricter targeting. Key messages:  Costs of return to work guidance within cardiac rehabilita- tion are higher at a rehabilitation centre than in a hospital.  Further research on whether costs outweigh effects of return to work guidance at rehabilitation centres and hospitals is needed. Cardiovascular risk factors and social determinants in a population study in Rio de Janeiro, Brazil Leonardo Ferreira L Ferreira 1 , V Flumignan 1 , B Marinho 1 , F Sampaio 1 , J Morais 1 , B Botelho 1 , T Mello 1 , R Silva 1 , A Fernandes 1 , E Muxfeldt 1 1 Campus Presidente Vargas, Medicine School, UNESA, Rio de Janeiro, Brazil Contact: leo.villaleao@gmail.com Background: The association of cardiovascular (CV) diseases and their risk factors with socioeconomic status has been well described, but its influence is often underestimated in epidemiological studies in Brazil. Objective: To evaluate the relationship between the main CV risk factors and socioeconomic indicators in a population of adults registered in a Family Health Care (FHC) unit in a great urban center - Rio de Janeiro, Brazil. Methods: Cross-sectional population study that included adults aged between 20 and 50 years living in the area covered by the FHC unit in Rio de Janeiro. Demographic data (gender and age), socioeconomic data (education level, profession, employ- ment), CV risk factors (smoking, sedentary lifestyle, obesity, hypertension, diabetes, dyslipidemia) were recorded. The metabolic profile is evaluated through laboratory tests. Those who studied up to high school were considered poorly educated. Results: 604 individuals were enrolled [39% male, mean age: 38.8  8,9 years] The median of schooling was 12 years. 288 individuals had high schooling, 44.5% were male. A total of 130 individuals did not study or work. Women with low education had a higher risk of smoking, obesity and hypertension with no difference regarding labor or study activities. Otherwise, men with low education had a higher risk of sedentary lifestyle and hypertension. Among men, not working or studying increased the risk of smoking and hypertension. Conclusions: We found an inverse association between socioeconomic conditions and the prevalence of CV risk factors. Women are more affected by low schooling, while men are more affected by their working occupation. The study suggests that socio- economic factors influence the CV risk, affecting men and women differently, pointing to the need for more compre- hensive public health policies that effectively reverse this situation. Key messages:  We found an inverse association between socioeconomic conditions and the prevalence of CV risk factors.  Socioeconomic factors influence cardiovascular risk differ- ently according to gender. Barriers and facilitators of adherence for cervical cancer prevention in low-income women in Colombia Paula Cristina Bermu ´ dez Jaramillo Bermu ´ dez PCJaramillo 1 , M Arrivillaga Quintero 1 , KJ Torres Poveda 2 , DM Castrillo ´ n Libreros 31 , D Neira Acevedo 3 , D Cuartas Arroyabe 5 , LE Castillo Castillo 4 1 Departamento de Salud Pu ´blica y Epidemiologı´a, Pontificia Universidad Javeriana Cali, Cali, Colombia 2 Chronic Infections and Cancer Division, National Institute of Public Health, Cuernavaca, Mexico 3 Hospital de Siloe ´ Siglo XXI, Red de Salud Ladera Empresa Social del Estado, Cali, Colombia 4 Information Center for Public Health Decisions, National Institute of Public Health, Cuernavaca, Mexico 5 Escuela de Salud Pu ´ blica, Universidad del Valle, Cali, Colombia Contact: paula.bermudez@javerianacali.edu.co Introduction: In Colombian women, cervical cancer screening coverage in 2017, 48.2 % of women were able to pay and 34.3% were not able to. Objective: To determine the barriers and facilitators of screening adherence to preventive program for cervical cancer preven- tion, in women were not able to pay affiliated to a public network of primary health care in Cali, Colombia, during the years 2014-2018. Methods: Sequential mixed study, quantitative initial phase and second qualitative phase. We analyzed information from 32,001 insured women and 7,691 users of the program. The quantitative design was cross-cutting, observational and analytical; we also incorporate a qualitative case study; we v946 European Journal of Public Health, Volume 30 Supplement 5, 2020 Downloaded from https://academic.oup.com/eurpub/article/30/Supplement_5/ckaa166.1116/5915492 by guest on 22 September 2023