Cardiac Rehabilitation Availability and Delivery in Canada: How does it Compare to other High-Income Countries?

dc.contributor.authorTran, Michelle
dc.contributor.authorPesah, Ella
dc.contributor.authorTurk-Adawi, Karam
dc.contributor.authorSupervia, Marta
dc.contributor.authorLopez-Jimenez, Francisco
dc.contributor.authorOh, P.
dc.contributor.authorBaer, Carolyn
dc.contributor.authorGrace, Sherry
dc.date.accessioned2025-06-11T22:04:12Z
dc.date.available2025-06-11T22:04:12Z
dc.date.issued2018-09-28
dc.description© 2018. This accepted manuscript is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
dc.description.abstractBackground Canada has insufficient cardiac rehabilitation (CR) capacity, yet unmet need is unknown. Moreover, Canada has CR guidelines, but whether delivery conforms has not been characterized by province/territory. This study aimed to establish (1) CR volumes, capacity, and density, as well as (2) the nature of programs, and (3) compare these (a) by province/territory and (b) with other high-income countries (HICs). Methods In this cross-sectional study, an online survey was administered to CR programs globally. National cardiac associations were engaged to facilitate program identification where available, or local champions. Density was computed using Canada’s Chronic Disease Surveillance System ischemic heart disease incidence estimates. Twenty-eight HICs with CR were selected for comparison (N = 619 programs), and multilevel analyses performed. Results CR was available in 10 of 13 (76.9%) provinces (no programs in Canada’s North), with 74 of 182 programs initiating a survey (40.7% response). Program volumes (median = 250) were greatest in Ontario, but ultimately there was only 1 CR spot per 4.55 patients with ischemic heart disease nationally (similar in other HICs), and 186,187 more spots are needed annually. Most programs were funded by government/hospital sources (n = 48, 66.7%), but in 23 (31.5%), patients paid some or all of program costs out-of-pocket. Guideline-indicated conditions were accepted in more than 90% of programs. Programs had a multidisciplinary team of 6.2 ± 2.1 staff, offering 7.7 ± 1.5/10 core components (varied by province, P = 0.001; return-to-work offered less frequently than other HICs; P = 0.03), over 42.0 ± 26.0 hours (provincial and other HIC differences, P < 0.001). Conclusions Canadian CR capacity must be augmented, but where available, services are consistent with other HICs.
dc.description.sponsorshipThis project was supported by a research grant from York University’s Faculty of Health. Publication of this article was supported by the Jim Pattison Foundation and the University Hospital Foundation.
dc.identifier.citationTran, M., Pesah, E., Turk-Adawi, K., Supervia, M., Lopez Jimenez, F., Oh, P., Baer, C., & Grace, S. L. (2018). Cardiac Rehabilitation Availability and Delivery in Canada: How Does It Compare With Other High-Income Countries? Canadian Journal of Cardiology, 34(10), S252–S262. https://doi.org/10.1016/j.cjca.2018.07.413
dc.identifier.issn0828-282X
dc.identifier.issn1916-7075
dc.identifier.urihttps://doi.org/10.1016/j.cjca.2018.07.413
dc.identifier.urihttps://hdl.handle.net/10315/42915
dc.language.isoen
dc.publisherElsevier
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 Internationalen
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.titleCardiac Rehabilitation Availability and Delivery in Canada: How does it Compare to other High-Income Countries?
dc.typeArticle

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