Related Experiment Video
Updated: Sep 21, 2025
A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
Published on: April 19, 2019
Trends and Factors Associated With Cardiac Rehabilitation Participation - Data From Japanese Nationwide Databases
Koshiro Kanaoka1,2, Yoshitaka Iwanaga1, Nagaharu Fukuma3
1Department of Medical and Health Information Management, National Cerebral and Cardiovascular Center.
Insights
Cardiovascular rehabilitation (CR) participation increased, but outpatient CR remains low for certain conditions. Higher age, comorbidities, and limited hospital resources hinder access, necessitating targeted interventions.
Area of Science:
- Cardiology
- Public Health
- Health Services Research
Background:
- Limited comprehensive data exists on cardiovascular rehabilitation (CR) participation trends and influencing factors across major cardiovascular diseases in Japan.
- Understanding these trends is crucial for improving patient outcomes and optimizing healthcare resource allocation.
Purpose of the Study:
- To describe nationwide trends in CR participation for patients with acute heart failure (AHF), acute coronary syndrome (ACS), acute aortic dissection (AAD), peripheral artery disease (PAD), and post-cardiovascular surgery.
- To evaluate patient- and hospital-level factors associated with CR participation in both inpatient and outpatient settings.
Main Methods:
- Nationwide cross-sectional study utilizing the National Database of Health Insurance Claims and Specific Health Checkups of Japan, the Japanese Registry of All Cardiac and Vascular Diseases, and the Diagnosis Procedure Combination database.
- Mixed-effect logistic regression analysis was employed to identify associated factors of CR participation.
Main Results:
- The annual number of patients undergoing CR increased, but outpatient CR participation remained lower than inpatient CR.
- Outpatient CR participation rates were notably lower for AHF (3.5%), AAD (3.2%), and PAD (1.7%) compared to ACS (7.9%) and post-surgery (9.4%).
- Significant factors associated with CR participation included age, sex, body mass index, Barthel index, Charlson comorbidity index, and institutional capacity.
Conclusions:
- Outpatient CR participation remains suboptimal, particularly for patients with AHF, AAD, and PAD.
- Higher patient age, multiple comorbidities, and lower institutional capacity are key contributors to reduced outpatient CR uptake.
- Identifying these associated factors is essential for developing strategies to enhance CR participation among cardiologists and healthcare providers.
Background:
Few studies have comprehensively evaluated the trends and factors associated with CR participation across major cardiovascular diseases in Japan.
Methods And Results:
This study performed a nationwide cross-sectional study using the National Database of Health Insurance Claims and Specific Health Checkups of Japan and the Japanese Registry of All Cardiac and Vascular Diseases and the Diagnosis Procedure Combination database. This study described the nationwide trends and evaluated patient- and hospital-level associated factors of CR participation for patients with acute heart failure (AHF), acute coronary syndrome (ACS), acute aortic dissection (AAD), peripheral artery disease (PAD), and after cardiovascular surgery using mixed-effect logistic regression analysis. Although the annual number of patients who underwent CR has increased during the study period, the total number of patients participating in outpatient CR was lower than that of inpatient CR. The outpatient CR participation rate was lower for patients with AHF (3.5%), AAD (3.2%), and PAD (1.7%), compared with ACS (7.9%) and after surgery (9.4%). Age, sex, body mass index, Barthel index, Charlson comorbidity index, and institutional capacity were identified as significant associated factors of CR participation in inpatient and outpatient settings.
Conclusions:
Participation in outpatient CR was still low, and higher age, multi-comorbidity, and low institutional capacity contributed to the lower outpatient CR participation rate. Identification of the associated factors may help cardiologists to increase CR participation.
More Related Videos
09:42Using Continuous Data Tracking Technology to Study Exercise Adherence in Pulmonary Rehabilitation
Published on: November 8, 2013
05:16Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
Published on: June 10, 2025
Related Concept Videos
01:26Coronary Artery Disease IV: Preventive Measures
01:30Factors Influencing Heart Rate
Let us explore the significant factors affecting heart rate, including age, body temperature, posture, acute pain, chemical influences,...
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
01:23Rheumatic Heart Disease I: Introduction
01:21Rheumatic Heart Disease III: Medical Management
01:29Heart Failure II: Pathophysiology