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A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
Published on: April 19, 2019
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Neighborhood Disadvantage and Risk of Hospitalization in a Home-Based Cardiac Rehabilitation Program After Acute
Barune Thapa1, Kristi Reynolds2,3, Mark Duggan4
1Department of Clinical Science Kaiser Permanente Bernard J. Tyson School of Medicine Pasadena CA USA.
Journal of the American Heart Association
|December 17, 2025
Summary
Home-based cardiac rehabilitation did not eliminate higher hospitalization risks for patients from disadvantaged neighborhoods after heart attacks. Targeted interventions are crucial to address socioeconomic disparities and improve cardiovascular outcomes for all populations.
Area of Science:
- Cardiology
- Public Health
- Health Services Research
Background:
- Cardiovascular disease (CVD) outcomes are disproportionately worse in socioeconomically disadvantaged neighborhoods.
- The effectiveness of home-based cardiac rehabilitation in mitigating CVD risk post-acute myocardial infarction (AMI) in these populations remains unexamined.
Purpose of the Study:
- To investigate the association between neighborhood socioeconomic disadvantage and hospitalization risk among patients undergoing home-based cardiac rehabilitation after AMI.
- To determine if home-based cardiac rehabilitation mitigates the impact of neighborhood deprivation on cardiovascular outcomes.
Main Methods:
- A retrospective cohort study included 420 adults hospitalized for AMI and enrolled in an 8-week home-based cardiac rehabilitation program.
- Neighborhood deprivation was assessed using the Neighborhood Deprivation Index, categorized into quartiles (Q1: least disadvantaged, Q4: most disadvantaged).
- All-cause inpatient hospitalization within 30 days, 90 days, and 12 months was the primary outcome, analyzed using logistic regression adjusted for covariates.
Main Results:
- Patients in the most disadvantaged quartile (Q4) exhibited higher hospitalization rates compared to the least disadvantaged (Q1) at 12 months (52.2% vs. 41.6%).
- Fully adjusted models revealed significantly higher odds of 30-day (OR, 2.04) and 12-month (OR, 2.03) hospitalizations for patients in Q4 versus Q1.
- Race and ethnicity showed no consistent association with hospitalization risk, although Black patients had lower 12-month hospitalization odds.
Conclusions:
- Neighborhood socioeconomic disadvantage is linked to increased hospitalization risk following AMI, even with home-based cardiac rehabilitation.
- Current home-based cardiac rehabilitation programs may not fully overcome the adverse effects of socioeconomic disparities.
- Additional interventions addressing structural inequities are necessary to improve cardiovascular outcomes for marginalized populations.
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