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A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
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Association of Cardiac Rehabilitation With Survival Among US Veterans

Nirupama Krishnamurthi1,2, David W Schopfer1,3, Hui Shen1,3

  • 1San Francisco Veterans Affairs Medical Center, San Francisco, California.

JAMA Network Open
|March 21, 2020
PubMed

Insights

Veterans participating in cardiac rehabilitation (CR) at Veterans Affairs (VA) or non-VA facilities showed similar 1-year mortality and readmission rates. These findings support participation in CR programs irrespective of the provider for patients with ischemic heart disease.

Area of Science:

  • Cardiology
  • Public Health
  • Health Services Research

Background:

  • Cardiac rehabilitation (CR) participation is low among Veterans Affairs (VA) patients, with most receiving care through non-VA programs.
  • Limited comparative data exists on outcomes between VA and non-VA CR programs.

Purpose of the Study:

  • To compare 1-year mortality and readmission rates for myocardial infarction or coronary revascularization between VA and non-VA CR participants.
  • To inform CR program utilization and patient care strategies within the VA system.

Main Methods:

  • A cohort study of 7320 veterans hospitalized for myocardial infarction or coronary revascularization between 2010-2014.
  • Comparison of 1-year all-cause mortality and readmission rates using Cox proportional hazards models with inverse probability treatment weighting.
  • Exclusion of patients who died within 30 days of discharge or did not participate in at least two CR sessions.

Main Results:

  • No significant difference in 1-year mortality rates between VA (1.7%) and non-VA (1.3%) CR participants (HR, 1.32; P=.15).
  • No significant difference in 1-year readmission rates for myocardial infarction or revascularization between VA (4.9%) and non-VA (4.4%) CR participants (HR, 1.06; P=.62).
  • Minority veterans were more likely to attend VA CR programs, while white veterans favored non-VA programs.

Conclusions:

  • Outcomes regarding 1-year mortality and readmission are comparable between VA and non-VA CR programs.
  • Veterans with ischemic heart disease are encouraged to participate in CR programs, regardless of the facility.
  • Findings support the effectiveness of CR services across different healthcare settings for veterans.
Abstract

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