The Quality and Variability of Cardiac Rehabilitation Delivery
dc.contributor.advisor | Grace, Sherry L. | |
dc.creator | Somanader, Deborah Shiranthi | |
dc.date.accessioned | 2015-12-16T19:23:51Z | |
dc.date.available | 2015-12-16T19:23:51Z | |
dc.date.copyright | 2015-07-27 | |
dc.date.issued | 2015-12-16 | |
dc.date.updated | 2015-12-16T19:23:51Z | |
dc.degree.discipline | Kinesiology & Health Science | |
dc.degree.level | Master's | |
dc.degree.name | MSc - Master of Science | |
dc.description.abstract | Background: Cardiac care, including cardiac rehabilitation (CR), is most effective if it is high-quality. The aim of this study was to describe CR quality, using the recently-developed Canadian Cardiovascular Society CR quality indicators (QIs). As secondary and tertiary objectives, site differences in quality were measured, and the criterion validity of 4 of the QIs in comparison to self-report data were established. Methods: Secondary analysis was conducted on an observational, prospective, multi-site CR program evaluation cohort. A convenience sample of patients from one of 3 CR programs was approached at their first CR visit, and consenting participants completed a survey. Clinical data were extracted from charts pre and post-program. Of the 30 CR QIs, 21 (70.0%) were assessable: 10 process, 9 outcome and 2 structure QIs. Results: Of 411 consenting patients, 209 (53.0%) completed CR. The greatest quality was observed for assessment of blood pressure (98.1%), communication with primary healthcare at CR discharge (94.2%), and patient enrollment (93.7%). The lowest quality was observed for wait time from hospital discharge (9.2%), assessments of blood glucose (42.1%), and lipid control (53.0%). Of the 7 QIs that had an established benchmark, quality for 2 (28.6%) was above the benchmark (particularly assessment of blood pressure). Significant site differences were observed in 11 (64.7%) QIs. The magnitude of quality differences between sites was largest for assessment of lipid control (72.6%), assessment of blood glucose control (69.0%), and wait time in median days from referral to enrollment (30.6 days). Validity was fair for QIs 2a and 3. None to slight validity was found for QI-17, and 18 respectively. Conclusion: There is wide variability in CR program quality, both overall and between CR sites. Quality improvement in particular aspects of CR care is required. | |
dc.identifier.uri | http://hdl.handle.net/10315/30699 | |
dc.language.iso | en | |
dc.rights | Author owns copyright, except where explicitly noted. Please contact the author directly with licensing requests. | |
dc.subject | Health sciences | |
dc.subject.keywords | cardiac rehabilitation | |
dc.subject.keywords | health services research | |
dc.subject.keywords | quality | |
dc.subject.keywords | performance improvement | |
dc.subject.keywords | care delivery | |
dc.title | The Quality and Variability of Cardiac Rehabilitation Delivery | |
dc.type | Electronic Thesis or Dissertation |
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