Cardiac Rehabilitation Referral and Attendance: Not One and the Same

King, Kathryn M.; Teo, Koon K.

doi:10.1002/j.2048-7940.1998.tb01794.x

Cited by 46 publications

(44 citation statements)

References 40 publications

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“…16 The receipt of a referral or a recommendation from a health professional has been a consistently important predictor of enrollment in cardiac rehabilitation in prior studies. 4,5,8,[23][24][25] The majority of our women (80%) who reported receiving information about cardiac rehabilitation from a health professional also reported enrolling in a program. However, only about one half of the women reported any knowledge of cardiac rehabilitation when asked 6 months after their hospital discharge, and less than 20% actually reported receiving a referral to enroll in a program.…”

Section: Discussionmentioning

confidence: 94%

“…Physician referral patterns, program characteristics, and patient-related factors, such as demographic, economic, health, and psychosocial factors, contribute to whether patients are referred to and whether they enroll and continue to attend cardiac rehabilitation programs. 8 However,there is a paucity of research that specifically addresses the facilitators for and barriers to cardiac rehabilitation in women and whether there are racial disparities in referral and attendance. Consistent with the Healthy People 2010 goal to eliminate health disparities among segments of the population, including differences that occur by gender, race, or ethnicity, 12 the purpose of this study was to determine the predictors of referral and enrollment, including racial differences, in phase 2 cardiac rehabilitation programs in African-American and white women who are eligible for such programs.…”

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confidence: 99%

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confidence: 99%

“…4,5 The few studies that have reported genderspecific data show that women have lower attendance and higher dropout rates from outpatient cardiac rehabilitation compared with men. [4][5][6][7][8][9] Although the data are limited, the dropout rate is even higher for African-American women compared with white women (49% vs 36%, respectively), 10 and a national survey revealed that only 9.3% of female participants in cardiac rehabilitation programs in 1990 were nonwhite. 11 These findings are striking because AfricanAmerican women have a greater incidence of CHD compared with white women and hence a greater proportion are presumably eligible for cardiac rehabilitation.…”

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confidence: 99%

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Disparities in women’s referral to and enrollment in outpatient cardiac rehabilitation

et al. 2004

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OBJECTIVE:The purpose of this study was to determine the predictors of referral and enrollment, including racial differences, in phase 2 cardiac rehabilitation programs among African-American and white women who are eligible for such programs. DESIGN: Prospective longitudinal design.SETTING: One large academic medical center and two large community hospitals. PATIENTS:A total of 253 women (108 African American, 145 white) were surveyed within the first month of discharge from the hospital for a percutaneous coronary intervention, coronary artery bypass surgery, or myocardial infarction without revascularization. A total of 234 (99 African American, 135 white) completed the 6-month follow-up. MAIN RESULTS:The rate of referral to outpatient phase 2 cardiac rehabilitation was significantly lower for AfricanAmerican women compared with white women, 12 (12%) versus 33 (24%) ( P = .03). Only 35 (15%) of women in the study reported enrollment in phase 2 cardiac rehabilitation programs, with fewer African-American women reporting enrollment compared with white women, 9 (9%) versus 26 (19%) ( P = .03). Controlling for age, education, angina class, and comorbidities, women with annual incomes <$20,000 were 66% less likely to be referred to cardiac rehabilitation ( P = .01) and 60% less likely to enroll compared to women with incomes >$20,000 ( P = .01). Although borderline significant, AfricanAmerican women were 55% less likely to be referred ( P = .059) and 58% less likely to enroll ( P = .059) than white women. CONCLUSIONS:We found disparities in cardiac rehabilitation program participation, with women with lower incomes less likely to be referred and to have lower enrollment rates in cardiac rehabilitation and a strong trend for African-American women to be less likely to be referred and enroll. Because almost all patients who have had an acute coronary event, with or without revascularization procedures, will benefit from cardiac rehabilitation, automatic referral systems should be considered to increase utilization and reduce disparities. Coronary heart disease (CHD) affects more than 50% of women, and is their major cause of disability and death.1 Cardiovascular disease accounts for more hospitalizations and health care costs than any other illness. Cardiac rehabilitation programs have been shown to reduce mortality, improve functional capacity, improve quality of life, and decrease the incidence of rehospitalization for cardiac complications and overall medical costs in both men and women. 2,3 Despite the preponderance of this evidence, less than 25% of patients eligible for cardiac rehabilitation services enroll in an early outpatient cardiac rehabilitation program. 4,5 The few studies that have reported genderspecific data show that women have lower attendance and higher dropout rates from outpatient cardiac rehabilitation compared with men. [4][5][6][7][8][9] Although the data are limited, the dropout rate is even higher for African-American women compared with white women (49% vs 36%, respectively), 10 and a n...

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Section: Discussionmentioning

confidence: 94%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Disparities in women’s referral to and enrollment in outpatient cardiac rehabilitation

et al. 2004

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“…46,62,194 Consequently, education of physicians and providers on the benefits of cardiac rehabilitation may help to improve referral and uptake. 37,46 This may be accomplished best by the involvement of referring physicians in the programme.…”

Section: Discussionmentioning

confidence: 99%

Provision, uptake and cost of cardiac rehabilitation programmes: improving services to under-represented groups

Beswick¹,

Rees²,

Griebsch³

et al. 2004

Health Technol Assess

221

153

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Cardiac Rehabilitation: Participating in an Exercise Program in a Quest to Survive

Mitchell¹,

Muggli²,

Sato³

1999

Rehabilitation Nursing

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Cardiovascular diseases are the major cause of death in the United States. The American Heart Association reports that approximately 500,000 persons die each year from heart attacks. Cardiac rehabilitation programs are based on objectives that would, when adhered to, extend and improve an individual's quality of life after experiencing a cardiac event. The purpose of this qualitative study was to explore and describe strategies that individuals who experienced a cardiac event used to overcome barriers associated with an exercise program. The sample consisted of six subjects (four females and two males) who were enrolled in a cardiac exercise program for 1 year or longer, and who continued to actively participate in at least two cardiac exercise classes per year. This study revealed that individuals who consistently participated in a cardiac exercise program did not use strategies to overcome barriers; rather, in their quest to survive, they used strategies to ensure their participation in the program.

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Cardiac Rehabilitation Referral and Attendance: Not One and the Same

Cited by 46 publications

References 40 publications

Disparities in women’s referral to and enrollment in outpatient cardiac rehabilitation

Disparities in women’s referral to and enrollment in outpatient cardiac rehabilitation

Provision, uptake and cost of cardiac rehabilitation programmes: improving services to under-represented groups

Cardiac Rehabilitation: Participating in an Exercise Program in a Quest to Survive

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