The Role of Clinical and Geographic Factors in the Use of Hospital versus Home-Based Cardiac Rehabilitation
| dc.contributor.author | Brual, Janette | |
| dc.contributor.author | Gravely, Shannon | |
| dc.contributor.author | Suskin, Neville | |
| dc.contributor.author | Stewart, Donna Eileen | |
| dc.contributor.author | Grace, Sherry L. | |
| dc.date.accessioned | 2013-06-24T14:19:50Z | |
| dc.date.available | 2013-06-24T14:19:50Z | |
| dc.date.issued | 2012-09 | |
| dc.description.abstract | Objective: Cardiac rehabilitation (CR) is most often provided in a hospital setting. Home-based models of care have been developed to overcome geographic, among other, barriers in patients at lower-risk. This study assessed whether clinical and geographic factors were related to use of either a hospital- or home-based program. Methods: Secondary analysis was undertaken within a study of 1268 cardiac outpatients recruited from 97 cardiologist practices where clinical data were extracted. Participants completed a survey including the Duke Activity Status Index. They reported CR utilization in a second survey mailed 9 months later, including CR site and program model. Geographic information systems was used to determine distances and drive times to the CR site attended from patients’ homes. Results: Overall, 469 (37.0%) participants attended CR at one of 41 programs. Of the 373 (79.5%) participants with complete geographic data, 43 (11.5%) reported attending home-based CR. The sole clinical difference was in activity status, where patients attending hospital-based program had lower activity status (p<.01). There were no differences in model attended based on geographic parameters including urban vs. rural dwelling or drive times (p>.05). Conclusions: Only one-tenth of outpatients participated in a home-based program, and this allocation was unrelated geographic considerations. While patients should continue to be appropriately-triaged based on clinical risk to ensure safety, more targeted allocation of patients to home-based services may be warranted. This may optimize degree of participation, and potentially patient outcomes. | en_US |
| dc.description.sponsorship | Canadian Institutes of Health Research (CIHR) grant MOP-74431 | |
| dc.identifier.citation | International Journal of Rehabilitation Research 35.3 (2012): 220-6. | |
| dc.identifier.uri | http://hdl.handle.net/10315/24292 | |
| dc.identifier.uri | https://dx.doi.org/10.1097/MRR.0b013e328353e375 | |
| dc.language.iso | en | en |
| dc.subject | Rehabilitation, Utilization | |
| dc.subject | Geography | |
| dc.subject | Health Services Research | |
| dc.subject | Access to CareCoronary Artery Disease | |
| dc.title | The Role of Clinical and Geographic Factors in the Use of Hospital versus Home-Based Cardiac Rehabilitation | |
| dc.type | Article |