Factors Associated With Referral to Outpatient Cardiac Rehabilitation Services

Abstract

Younger age, previous participation in outpatient cardiac rehabilitation, admission to a hospital that provides outpatient cardiac rehabilitation, a discharge diagnosis of acute myocardial infarction, and coronary artery bypass surgery were associated with referral to cardiac rehabilitation. Research testing strategies designed to increase cardiac rehabilitation referral rates are needed and could include testing the potential role of modern quality management methods.

Cardiac Rehabilitation Barriers and Opportunities Among Women With Cardiovascular Disease

“…2,4,31 However, there are conflicting reports regarding gender as an independent predictor of referral. Results of several studies, adjusting for important patient, provider, or hospital factors found that other factors, rather than gender, were independent predictors of the referral process, 36,57,61 whereas other studies found female gender to be a significant predictor. 48,49,62 …”

“…42,43 Whether or not the hospital offers outpatient cardiac rehabilitation influences compliance with discharge referrals. 57 Patients who were discharged from hospitals that offered cardiac rehabilitation services were 5 times more likely to be referred to cardiac rehabilitation than hospitals lacking this service. 57 Hospitals without a formal phase II affiliation need to take note of these results and create seamless referral processes to other hospital or communitybased programs.…”

“…57 Patients who were discharged from hospitals that offered cardiac rehabilitation services were 5 times more likely to be referred to cardiac rehabilitation than hospitals lacking this service. 57 Hospitals without a formal phase II affiliation need to take note of these results and create seamless referral processes to other hospital or communitybased programs. Patients who live in communities without a local program are significantly more likely not to have a referral, due to lack of access.…”

Universal access: But when? Treating the right patient at the right time: Access to cardiac rehabilitation

“…Access and referral to CR Despite the documented benefits of CR and the fact that practice guidelines recommend that CR be offered to all patients with CVD, there are inconsistencies in referral practices that generally result in inequality in referral and access to CR (21,22). It has been found that an enhanced referral rate to CR is associated with:…”

The Canadian Heart Health Strategy and Action Plan: Cardiac rehabilitation as an exemplar of chronic disease management

“…The cause and variance between jurisdictions of CR underuse relate to patient and health system factors (23). Factors that have been associated with increased CR referral and attendance are discharge diagnosis of acute myocardial infarction or coronary artery bypass surgery, age less than 65 years, previous participation in CR (24) and male sex (25). Thus, a systematic approach to universal referral to CR has the potential to improve CR uptake, as demonstrated in the Ontario CRPP, in which a systematic CR referral process increased CR participation among eligible patients from approximately 15% to 25% in just six months (15).…”