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Cardiac rehab participation low, varies by region
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Among Medicare patients and those from the Veterans Affairs health care system who had MI and/or underwent CABG or PCI, cardiac rehabilitation rates were low, but varied by region, according to findings published in Circulation.
“Patients who don’t get the rehab may have difficulty accessing it easily, especially rural patients, and others may be less motivated. It’s really inexplicable to me why participation rates are so low,” Alexis L. Beatty, MD, MAS, cardiologist at the VA Puget Sound Health Care System and assistant professor of cardiology at the University of Washington School of Medicine, said in a press release. “People who get cardiac rehab are usually glad they did.”
Beatty and colleagues identified 143,756 patients from Medicare databases and 88,826 patients from VA databases hospitalized between 2007 and 2011 for MI, CABG and/or PCI.
Patients were stratified by whether they participated in at least one outpatient visit for cardiac rehabilitation within the 12 months after hospitalization. Patients who died within 30 days of hospitalization were excluded.
Among the Medicare cohort, 16.3% of patients participated in cardiac rehabilitation, whereas among the VA cohort, 10.3% participated, according to the researchers.
Participation rates varied widely across states, ranging from 3.2% to 41.8% in the Medicare group (median OR = 1.81; 95% CI, 1.63‒1.99) and from 1.2% to 47.6% in the VA group (median OR = 2.05; 95% CI, 1.56-2.06), Beatty and colleagues wrote.
The West North Central region had the highest rate of participation among regions (Medicare group, 33.7%; VA group, 16.6%), whereas the Pacific region had the lowest rate (Medicate group, 10.6%; VA group, 5.1%), according to the researchers.
Participation also varied widely at the hospital level, ranging from 3% to 75% in the Medicare cohort (median OR = 1.78; 95% CI, 1.74-1.82) and from 1% to 43% in the VA cohort (median OR = 2.57; 95% CI, 2.17-2.96).
“It’s weird that the VA and Medicare maps are pretty similar,” Beatty said in the release. “It suggests, if anything, that it’s more regional practice patterns are the main influencers [on whether patients participate]. Some cardiologists do a better job at getting their patients to attend cardiac rehab.” – by Erik Swain
Disclosure: The authors report no relevant financial disclosures.
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