Medical College of Wisconsin
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Cardiac rehabilitation enrollment among referred patients: patient and organizational factors. J Cardiopulm Rehabil Prev 2014 Mar-Apr;34(2):114-22

Date

10/22/2013

Pubmed ID

24142042

DOI

10.1097/HCR.0000000000000017

Scopus ID

2-s2.0-84896709319   21 Citations

Abstract

PURPOSE: Cardiac rehabilitation (CR) is underutilized despite well-documented benefits for patients with coronary heart disease. The purpose of this study was to identify organizational and patient factors associated with CR enrollment.

METHODS: Facilities of the Wisconsin Cardiac Rehabilitation Outcomes Registry (N = 38) were surveyed, and the records of referred patients were analyzed. Generalized estimating equations were used to account for clustering of patients within facilities.

RESULTS: Of the 6874 patients referred to the 38 facilities, 67.6% (n = 4,644) enrolled in CR. Patients receiving coronary artery bypass grafting (adjusted odds ratio [OR], 1.72; 95% CI: 1.36-2.19) and those who possessed health insurance (OR, 3.04; 95% CI: 2.00-4.63) were more likely to enroll. Enrollment was also positively impacted by organizational factors, including promotion of CR program (OR, 2.35; 95% CI: 1.39-4.00), certification by the American Association of Cardiovascular Pulmonary Rehabilitation (OR, 2.63; 95% CI: 1.32-5.35), and a rural location (OR, 3.30; 95% CI: 2.35-4.64). Patients aged ≥65 years (OR, 0.81; 95% CI: 0.74-0.90) and patients with heart failure (OR, 0.40; 95% CI: 0.22-0.72), diabetes (OR, 0.58; 95% CI: 0.37-0.89), myocardial infarction without a cardiac procedure (OR, 0.78; 95% CI: 0.67-0.90), previous coronary artery bypass grafting (OR, 0.72; 95% CI: 0.56-0.92), depression (OR, 0.56; 95% CI: 0.36-0.88), or current smoking (OR, 0.59; 95% CI: 0.44-0.78) were less likely to enroll.

CONCLUSIONS: Predictors of patient enrollment in CR following referral included both organizational and personal factors. Modifiable organizational factors that were associated either positively or negatively with enrollment in CR may help directors of CR programs improve enrollment.

Author List

Turk-Adawi KI, Oldridge NB, Tarima SS, Stason WB, Shepard DS

Author

Sergey S. Tarima PhD Associate Professor in the Institute for Health and Equity department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Age Factors
Aged
Certification
Coronary Artery Bypass
Coronary Disease
Depression
Diabetes Mellitus
Female
Heart Failure
Humans
Insurance, Health
Logistic Models
Male
Marketing of Health Services
Myocardial Infarction
Patient Acceptance of Health Care
Referral and Consultation
Registries
Rehabilitation Centers
Rural Health Services
Smoking
Wisconsin
jenkins-FCD Prod-486 e3098984f26de787f5ecab75090d0a28e7f4f7c0