ArticleBMJ open2020
Influence of socioeconomic status on the referral process to cardiac rehabilitation following acute coronary syndrome: a cross-sectional study.
Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.
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Who cites it
10 citing papers in PubMed, 2 syntheses or guidelines pooled it, 25 citations in OpenAlex.
- Strategies to improve adherence to exercise-based phase II cardiac rehabilitation after percutaneous coronary intervention: a best evidence summary.Frontiers in cardiovascular medicine · 2026Pooled it
- Socioeconomic variation in the relationship between cardiac rehabilitation participation and clinical outcomes: a systematic review.Open heart · 2025Pooled it
- The Accessibility and Effect of Cardiac Rehabilitation in COVID-19 Pandemic Era.Annals of rehabilitation medicine · 2024Article
- Clinical effectiveness of cardiac rehabilitation and barriers to completion in patients of low socioeconomic status in rural areas: A mixed-methods study.Clinical rehabilitation · 2024Article
- Advances, Challenges, and Progress in Cardiac Rehabilitation in Chronic CVD Management.Current atherosclerosis reports · 2023Review
- Barriers and Facilitators to Delivering Inpatient Cardiac Rehabilitation: A Scoping Review.Journal of multidisciplinary healthcare · 2023Article
- Referral rate of chronic kidney disease patients to a nephrologist in the Region of Southern Denmark: results from KidDiCo.Clinical kidney journal · 2022Article
- Racial and Ethnic Differences in Cardiac Rehabilitation Participation: Effect Modification by Household Income.Journal of the American Heart Association · 2022Article
- Article
- Association of Socioeconomic Status With Outcomes and Care Quality in Patients Presenting With Undifferentiated Chest Pain in the Setting of Universal Health Care Coverage.Journal of the American Heart Association · 2022Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate the association between socioeconomic status (SES) and referral to cardiac rehabilitation (CR) after incident acute coronary syndrome (ACS) by dividing the referral process into three phases: (1) informed about CR, (2) willingness to participate in CR, (3) and assigned CR setting.
designCross-sectional study.
settingDepartment of Cardiology at a Danish University Hospital from 1 January 2011 to 31 December 2014.
participantsA total of 1229 patients assessed for CR during hospitalisation with ACS were prospectively registered in the Rehab-North Register from 2011 to 2014. SES was assessed using data from national registers, concerning: personal income, occupational status, educational level and civil status. Patients were excluded if one of the following criteria was fulfilled: (1) missing data on SES, or (2) acceptable reason for not informing patients about CR (treatment with coronary artery bypass grafting, transfer to another hospital, still under treatment or death).
main outcome measuresOutcomes were defined by dividing the referral process into three phases: (1) informed about CR, (2) willingness to participate, and (3) assigned CR setting (in-hospital/community centre) after ACS.
resultsA total of 854 (69.5 %) patients were referred to CR. After adjustment for age, gender, ACS diagnosis (ST-elevated myocardial infarction, non-ST-elevated myocardial infarction, unstable angina pectoris) and comorbidity, high income had the strongest association of referral to CR in all three phases (informed about CR: OR 2.17, 95% CI 1.01 to 4.64; willingness to participate in CR: OR 1.55, 95% CI 1.02 to 2.35; assigned in-hospital CR: OR 1.47, 95% CI 0.91 to 2.36). Educational level showed similar tendencies, however not statistically significant. The results did not vary according to gender.
conclusionThis is the first study to investigate the referral process to CR using a three-phase structure. It suggests income and education to influence all phases in the referral process to CR after ACS.
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