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Impact of Cardiac Rehabilitation Health Insurance Coverage on Cardiac Rehabilitation Use in Korea Using an

Yu Shin Park1,2, In Sun Song3, Suk-Yong Jang2,4

  • 1Department of Public Health Graduate School, Yonsei University Seoul Republic of Korea.

Journal of the American Heart Association
|January 31, 2024
PubMed

Insights

National Health Insurance coverage for cardiac rehabilitation (CR) in Korea significantly increased initial CR use probability. However, long-term CR utilization remained unchanged, with educational programs preferred over exercise programs.

Area of Science:

  • Cardiology
  • Health Services Research
  • Public Health Policy

Background:

  • South Korea's National Health Insurance began covering cardiac rehabilitation (CR) in 2017 to reduce patient financial burdens.
  • This study investigates the impact of this policy change on CR program utilization patterns.

Purpose of the Study:

  • To analyze the trends in CR program use among patients who underwent percutaneous coronary intervention (PCI) following the implementation of national health insurance coverage.
  • To compare the uptake of educational versus exercise-based CR programs.

Main Methods:

  • Retrospective analysis of electronic medical records from a tertiary hospital in Seoul, Korea (January 2014 - February 2020).
  • Inclusion of 2988 patients with acute coronary syndrome who underwent PCI.
  • Quarterly aggregation of data and segmented regression analysis of interrupted time series to evaluate policy impact on CR use.

Main Results:

  • Policy implementation led to a significant, prompt increase in the probability of CR use (OR, 3.99).
  • No significant change in overall CR use was observed after the policy implementation (OR, 0.97).
  • Patients were more likely to choose CR programs focused on education (OR, 87.44) compared to exercise-based programs (OR, 1.99).

Conclusions:

  • The introduction of CR coverage rapidly increased the initial likelihood of patients entering CR programs.
  • Educational CR programs demonstrated significantly higher utilization rates than exercise-based programs.
  • Despite initial uptake, sustained low CR utilization necessitates strategies to enhance program accessibility and adoption.
Abstract

Keywords:
cardiac rehabilitationcardiovascular diseasesmyocardial infarctionstroke

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