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National Survey on Gender Differences in Cardiac Rehabilitation Programs. Patient characteristics and enrollment
R J Thomas1, N H Miller, C Lamendola
1Department of Preventive Medicine, Northwestern University School of Medicine, Chicago, Illinois, USA.
Journal of Cardiopulmonary Rehabilitation
|November 1, 1996
Summary
Enrollment in cardiac rehabilitation (CR) programs is low for eligible patients, especially women and the elderly. New strategies are needed to increase participation in CR services for heart disease patients.
Area of Science:
- Cardiology
- Public Health
- Health Services Research
Background:
- Cardiac rehabilitation (CR) offers significant health benefits for coronary heart disease (CHD) patients.
- Limited data exists on the enrollment rates of eligible CHD patients in CR programs.
Purpose of the Study:
- To estimate the percentage of eligible patients with coronary heart disease (CHD) who enroll in outpatient (Phase II) cardiac rehabilitation (CR) programs.
- To identify demographic factors associated with CR enrollment post-myocardial infarction (MI), coronary angioplasty (PTCA), or coronary artery bypass surgery (CABS).
Main Methods:
- A survey of 500 randomly selected CR programs in the US during 1990.
- Combined survey data with the 1990 National Hospital Discharge Survey to assess patient enrollment.
- Analyzed enrollment data for patients undergoing MI, PTCA, or CABS.
Main Results:
- Only a minority of patients initiated CR: 10.8% post-MI, 10.3% post-PTCA, and 23.4% post-CABS.
- Women showed lower enrollment rates than men, particularly post-MI (6.9% vs. 13.3%) and post-CABS (20.2% vs. 24.6%).
- Enrollment was lowest among nonwhites, individuals over 65, and those in the southern US.
Conclusions:
- Cardiac rehabilitation programs are underutilized by eligible patients, with notable disparities for women, nonwhites, and the elderly.
- Current CR utilization falls short of national guidelines recommending services for most post-MI, PTCA, or CABS patients.
- Innovative approaches are essential to expand CR service delivery in clinical settings to meet patient needs and national recommendations.