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Attendance rates and outcomes of cardiac rehabilitation in Victoria, 1998
Author(s) -
Sundararajan Vijaya,
Begg Stephen,
Marshall Ric,
Bunker Stephen J,
McBurney Helen
Publication year - 2004
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.2004.tb05923.x
Subject(s) - medicine , rehabilitation , attendance , myocardial infarction , hazard ratio , cohort , comorbidity , physical therapy , psychological intervention , emergency medicine , psychiatry , confidence interval , economics , economic growth
Objective: To describe the patterns of use of cardiac rehabilitation in Victoria and to assess whether the survival benefits predicted in clinical trials have been realised in the community. Design: Cohort study based on data linkage. Participants: All patients admitted for acute myocardial infarction (AMI), coronary artery bypass grafting (CABG) or percutaneous transluminal coronary angioplasty (PTCA) in Victoria in 1998 ( n = 12 821). Interventions: Attendance at one of 66 participating outpatient cardiac rehabilitation centres in Victoria. Main outcome measures: Rates of attendance at rehabilitation based on key factors such as diagnosis, age, sex, and comorbidity. Five‐year survival for attendees compared with non‐attendees. Results: Rates of participation in rehabilitation were 15% for AMI, 37% for CABG, and 14% for PTCA. Rehabilitation attendance rates dropped sharply after 70 years of age. Attendees had a 35% improvement in 5‐year survival (hazard ratio for death associated with rehabilitation attendance, 0.65 [95% CI, 0.56–0.75]). Conclusions: Attendance rates at cardiac rehabilitation are suboptimal, even though attendance confers a clinically significant difference in 5‐year survival. The elderly, women, and those with comorbid conditions may benefit measurably from increased rates of attendance.