Continuity of cardiac care: Cardiac rehabilitation participation and other correlates

Background: Continuity of care refers to the ongoing management of a patient's care over time and across practitioners, and the patient's experience of this care as coherent and consistent with their medical needs and context. Continuity of cardiac care is integral to secondary prevention and improved health outcomes. Design: This study examined patient perceptions of continuity, and how they relate to cardiac rehabilitation participation and other correlates. Methods: Consecutive acute coronary syndrome patients at 3 hospitals were approached, and 661 consented to complete a survey (504 men, 157 women; 75% response rate). Nine months later, 506 participants completed a survey including the Heart Continuity of Care Questionnaire, open-ended continuity perceptions, and self-reported cardiac rehabilitation participation (yes/no). Results: The mean continuity perceptions were highly positive, and were equivalent to those found in another Canadian province, although open-ended responses revealed discontinuity with regard to outpatient visits and pharmacotherapy prescriptions. In a multivariate model (p=.003), the correlates of greater perceptions of continuity of cardiac care 9 months post-discharge were cardiac rehabilitation participation (p<.05), greater tangible support (p<.05), and less serious perceptions of illness consequences (p<.001) at the time of the acute coronary syndrome, after controlling for demographic and clinical factors. Conclusion: Given the benefits of continuity of care, it is important to promote cardiac rehabilitation participation, a significant correlate of continuity, and to solicit various supports throughout the process of cardiac recovery.