Geographic Variation in Cardiac Rehabilitation Participation in Medicare and Veterans Affairs Populations

Abstract

Cardiac rehabilitation participation remains low overall in both Medicare and VA populations. However, remarkably similar regional variation exists, with some regions and hospitals achieving high rates of participation in both populations. This provides an opportunity to identify best practices from higher performing hospitals and regions that could be used to improve cardiac rehabilitation participation in lower performing hospitals and regions.

Impact of Cardiac Rehabilitation on Functional Capacity and Physical Activity after Coronary Revascularization: A Scientific Review

“…As a major clinical outcome of cardiac rehabilitation, functional capacity has been one of the key factors in secondary prevention of CVD [4]. Coronary revascularization procedures have been shown to negatively affect functional capacity in patients, which may lead to sedentary lifestyle adaptations [38,39]. Submaximal exercise stress tests, with better applicability, including performance tests such as six-minute walk test (6MWT) are frequently applied for evaluating functional capacity [40].…”

Implementing recommendations for inpatient healthcare provider encouragement of cardiac rehabilitation participation: development and evaluation of an online course

“…The benefits of CR include 20% reductions in morbidity and CV mortality [7]. Despite the benefits, CR utilization is low [8][9][10][11][12]. One of the main reasons is lack of referral and encouragement by healthcare providers (HCPs) [13].…”

Promoting patient utilization of outpatient cardiac rehabilitation: A joint International Council and Canadian Association of Cardiovascular Prevention and Rehabilitation position statement

“…With regard to enrolment, the largest and most recent cohort where this was assessed using administrative data was in the United States, where enrolment rates of 16.3% were reported in Medicare beneficiaries (≥65 years) post-myocardial infarction or revascularization [18]. Again, the only population-based data of which we are aware with verified adherence stems from the United States, and showed that 40% of Medicare beneficiaries attended ≥30/36 and 13% of included participants attended b6 of 36 prescribed sessions [19].…”