Evidence map›Paper›PMID 41455385›Full record

ArticleJACC. Advances2026

Travel Distance, Urbanicity, and Cardiac Rehabilitation Participation in Medicare Beneficiaries.

Usman Khan, Jie Yang, Tyler M Bauer, Maximilian A Fliegner, Devraj Sukul, Steven J Keteyian, Robert B Hawkins, Donald S Likosky, Michael P Thompson

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in JACC. Advances, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Usman KhanDepartment of Cardiac Surgery, University of Michigan, Ann Arbor, Michigan, USA.
Jie YangDepartment of Cardiac Surgery, University of Michigan, Ann Arbor, Michigan, USA.
Tyler M BauerDepartment of Cardiac Surgery, University of Michigan, Ann Arbor, Michigan, USA.
Maximilian A FliegnerOakland University William Beaumont School of Medicine, Auburn Hills, Michigan, USA.
Devraj SukulCorewell Health, Grand Rapids, Michigan, USA.
Steven J KeteyianDivision of Cardiovascular Medicine, Henry Ford Hospital, Detroit, Michigan, USA.
Robert B HawkinsDepartment of Cardiac Surgery, University of Michigan, Ann Arbor, Michigan, USA.
Donald S LikoskyDepartment of Cardiac Surgery, University of Michigan, Ann Arbor, Michigan, USA; Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, Michigan, USA.
Michael P ThompsonDepartment of Cardiac Surgery, University of Michigan, Ann Arbor, Michigan, USA; Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, Michigan, USA. Electronic address: mthomps@med.umich.edu.

Funding

AHRQ HHS K01 HS027830
6 · The paper itself

Abstract

backgroundCardiac rehabilitation (CR) is a key intervention for patients recovering from major cardiovascular procedures, but access may be limited.

objectivesThe purpose of this study was to evaluate the relationship between travel distance to the nearest CR facility, degree of urbanicity, and CR participation.

methodsA retrospective cohort study was conducted on a sample of 100% Medicare fee-for-service claims for beneficiaries with a recent cardiovascular procedure between July 2016 and December 2018. Travel distance between the beneficiary and nearest CR facility was estimated using estimated travel distance between zip codes using Google Maps and categorized as being within the same zip code, 1-15 miles, 16-30 miles, and 30+ miles. Urbanicity was classified as urban, suburban, small town, and rural using U.S. Census data. Multivariable logistic regression compared CR enrollment (attending at least one session) and completion rates (attending 36 sessions or more) across distance and urbanicity categories.

resultsOf the 501,049 beneficiaries in the sample, 76% of urban beneficiaries lived within 15 miles of the nearest CR facility (80,182/84,345), and 63% of rural beneficiaries 15 miles away or more (70,892/112,697). CR enrollment was highest among beneficiaries living within the same zip code as a CR facility (45.6%, 53,935/118,642) and lowest among those living 30 or more miles from the nearest CR facility (19.5%, 7,462/38,309), with an adjusted difference of -22.6 (95% CI: -23.1 to -22.0; P < 0.001). In rural areas, the effect of travel distance on CR enrollment and completion was significantly greater when compared with individuals in urban areas.

conclusionsIncreased travel distance was associated with lower overall CR participation, with the effect varying by local degree of urbanicity.

Indexed as

access to carecardiac rehabilitationgeographyMedicare

Identifiers

PMID41455385
PMCPMC12797041

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