Cardiac rehabilitation uptake and its determinants in the Netherlands

被引:58
|
作者
van Engen-Verheul, Mariette [1 ]
de Vries, Han [2 ]
Kemps, Hareld [1 ,3 ]
Kraaijenhagen, Roderik [4 ,5 ]
de Keizer, Nicolette [1 ]
Peek, Niels [1 ]
机构
[1] Univ Amsterdam, Amsterdam, Netherlands
[2] Achmea Zorg & Gezondheid, Leiden, Netherlands
[3] Maxima Med Ctr, NL-5500 MB Veldhoven, Netherlands
[4] Netherlands Soc Cardiol, Comm Cardiovasc Prevent & Rehabil, Utrecht, Netherlands
[5] NIPED, Amsterdam, Netherlands
关键词
Cardiac rehabilitation; healthcare quality; secondary prevention; AMERICAN-HEART-ASSOCIATION; CORONARY-ARTERY-DISEASE; SECONDARY PREVENTION; ENROLLMENT; PROGRAMS; EXERCISE; EVENTS;
D O I
10.1177/2047487312439497
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aims: Despite its documented efficacy, cardiac rehabilitation (CR) is still not well implemented in current clinical practice. The aims of the present study were to assess CR uptake rates in the Netherlands, and to identify factors that determine uptake. Methods: The cohort consisted of persons insured with Achmea Zorg en Gezondheid. Based on insurance claims, we assessed CR uptake rates in 2007 among patients with an acute coronary syndrome (ACS), patients who underwent coronary artery bypass graft surgery, percutaneous coronary intervention (PCI), or valvular surgery, and patients with stable angina pectoris (AP) or chronic heart failure (CHF). In addition, we evaluated the relation between CR uptake and demographic, disease-related, and geographic factors for patients with an ACS and/or intervention. Results: The CR uptake rate in the entire cohort (n = 35,752) was 11.7%. The uptake rate among patients with an ACS and/or intervention (n = 12,201) was 28.5%, as opposed to 3.0% among patients with CHF or stable AP (n 23,551). The highest CR uptake rate was observed in patients who underwent cardiac surgery (58.7%). Factors associated with lower CR uptake were female gender, older age, elective PCI (as compared to acute PCI), unstable AP (as compared to myocardial infarction), larger distance to the nearest provider of CR, and comorbidity. Conclusion: A minority of Dutch patients eligible for CR received CR. Future implementation strategies should focus on females, elderly patients, patients with unstable AP and/or after elective PCI, patients with long travelling distances to the nearest CR provider, and patients with comorbidities.
引用
收藏
页码:349 / 356
页数:8
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