ArticleJournal of cardiopulmonary rehabilitation and prevention
The role of systematic inpatient cardiac rehabilitation referral in increasing equitable access and utilization.
Article in Journal of cardiopulmonary rehabilitation and prevention. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed, 50 citations in OpenAlex.
- Network characteristics of a referral system for patients with hypertension in Western Kenya: results from the Strengthening Referral Networks for Management of Hypertension Across the Health System (STRENGTHS) study.BMC health services research · 2022Trial
- Trial
- [Baseline characteristics and changes in treatment after a period of optimization of the patients included in the study EFICAR].Atencion primaria · 2016Trial
- Cardiac Rehabilitation Trends Among Commercially Insured Adults in the United States, 2017-2023.Circulation. Cardiovascular quality and outcomes · 2025Article
- Breaking barriers: assessing the impact of clinical quality improvements on reducing health disparities in hypertension care among Mumbai's urban slums.BMJ open quality · 2024Article
- Artificial intelligence-driven virtual rehabilitation for people living in the community: A scoping review.NPJ digital medicine · 2024Article
- Challenges in Effective Referral of Cardiovascular Diseases in Nepal: A Qualitative Study from Health Workers' and Patients' Perspective.Cardiology research and practice · 2024Article
- Trends in cardiac rehabilitation enrollment post-coronary artery bypass grafting upon implementation of automatic referral in Southeast Asia: A retrospective cohort study.Journal of cardiovascular and thoracic research · 2022Article
- Remotely monitored telerehabilitation for cardiac patients: A review of the current situation.World journal of clinical cases · 2020Review
- Article
- Article
- Cardiac Rehabilitation Utilization During an Acute Cardiac Hospitalization: A NATIONAL SAMPLE.Journal of cardiopulmonary rehabilitation and prevention · 2019Article
- Inequalities in access to cardiac rehabilitation after an acute coronary syndrome: the EPiHeart cohort.BMJ open · 2018Article
- Cardiac Rehabilitation Following Acute Coronary Syndrome in Women.Current treatment options in cardiovascular medicine · 2017Review
- Cardiac Rehabilitation for Women: A Systematic Review of Barriers and Solutions.Mayo Clinic proceedings · 2017Review
- Observational
- The Canadian Cardiac Rehabilitation Registry: Inaugural Report on the Status of Cardiac Rehabilitation in Canada.Rehabilitation research and practice · 2015Article
- Effect of referral strategies on access to cardiac rehabilitation among women.European journal of preventive cardiology · 2014Observational
- Cardiac rehabilitation barriers by rurality and socioeconomic status: a cross-sectional study.International journal for equity in health · 2013Article
- State-by-state variations in cardiac rehabilitation participation are associated with educational attainment, income, and program availability.Journal of cardiopulmonary rehabilitation and preventionArticle
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
backgroundWhile systematic referral strategies have been shown to significantly increase cardiac rehabilitation (CR) enrollment to approximately 70%, whether utilization rates increase among patient groups who are traditionally underrepresented has yet to be established. This study compared CR utilization based on age, marital status, rurality, socioeconomic indicators, clinical risk, and comorbidities following systematic versus nonsystematic CR referral.
methodsCoronary artery disease inpatients (N = 2635) from 11 Ontario hospitals, utilizing either systematic (n = 8 wards) or nonsystematic referral strategies (n = 8 wards), completed a survey including sociodemographics and activity status. Clinical data were extracted from charts. At 1 year, 1680 participants completed a mailed survey that assessed CR utilization. The association of patient characteristics and referral strategy on CR utilization was tested using χ.
resultsWhen compared to nonsystematic referral, systematic strategies resulted in significantly greater CR referral and enrollment among obese (32 vs 27% referred, P = .044; 33 vs 26% enrolled, P = .047) patients of lower socioeconomic status (41 vs 34% referred, P = .026; 42 vs 32% enrolled, P = .005); and lower activity status (63 vs 54% referred, P = .005; 62 vs 51% enrolled, P = .002). There was significantly greater enrollment among those of lower education (P = .04) when systematically referred; however, no significant differences in degree of CR participation based on referral strategy.
conclusionUp to 11% more socioeconomically disadvantaged patients and those with more risk factors utilized CR where systematic processes were in place. They participated in CR to the same high degree as their nonsystematically referred counterparts. These referral strategies should be implemented to promote equitable access.
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Registered trials
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