Gender differences in referral to cardiac rehabilitation programs after revascularization

Area of Science:

• Cardiovascular Medicine
• Health Services Research
• Gender Health Disparities

Background:

• Cardiac rehabilitation (CR) significantly reduces mortality and morbidity post-coronary revascularization.
• Despite benefits, referral rates to CR programs remain low for both genders.
• A specific university CR program's patient demographic was heavily skewed, with 88% men and 12% women.

Purpose of the Study:

• To investigate the influence of gender on secondary prevention instruction and CR referral post-coronary revascularization.
• To identify potential gender-based disparities in healthcare provider communication regarding CR.

Main Methods:

• A matched case observational study involving 80 patients (40 men, 40 women) who underwent coronary revascularization (1997-1998).
• Patients were matched for age and type of revascularization procedure (e.g., angioplasty, stenting, CABG).
• Data collected via questionnaire on secondary prevention education and CR referral status.

Main Results:

• Women were significantly less likely than men to receive secondary prevention instruction and CR referrals, despite matching for age and procedure type.
• A statistically significant gender difference was observed in hospital teaching and referral information for CR (P < 0.001).
• Being female was independently associated with a lower likelihood of receiving a physician referral to CR post-revascularization (P < 0.001).

Conclusions:

• Overall patient instruction on secondary prevention and CR post-revascularization is inadequate.
• Women are significantly underrepresented in discussions about CR and subsequent referrals by healthcare professionals.
• There is a critical need for educational initiatives targeting healthcare providers to emphasize the benefits of CR for all patients, particularly women.