The Role of Clinical and Geographic Factors in the Use of Hospital versus Home-Based Cardiac Rehabilitation

Autor/inn/en	Brual, Janette; Gravely, Shannon; Suskin, Neville; Stewart, Donna E.; Grace, Sherry L.
Titel	The Role of Clinical and Geographic Factors in the Use of Hospital versus Home-Based Cardiac Rehabilitation
Quelle	In: International Journal of Rehabilitation Research, 35 (2012) 3, S.220-226 (7 Seiten) PDF als Volltext Verfügbarkeit
Sprache	englisch
Dokumenttyp	gedruckt; online; Zeitschriftenaufsatz
ISSN	0342-5282
Schlagwörter	Patients; Hospitals; Geographic Information Systems; Heart Disorders; Residential Institutions; Surveys; Human Body; Foreign Countries; Risk; Rehabilitation; Canada + Suchen Sie Ihr Suchwort? Patient; Krankengymnast; Krankenhaus; Herzkrankheit; Wohnumgebung; Survey; Umfrage; Befragung; Menschlicher Körper; Ausland; Risiko; Kanada
Abstract	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 a lower risk. This study assessed whether clinical and geographic factors were related to the use of either a hospital-based or a home-based program. 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 were used to determine the distances and the drive times to the CR site attended from patients' homes. 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 a hospital-based program had lower activity status (P less than 0.01). There were no differences in model attended on the basis of geographic parameters including urban versus rural dwelling or drive times (P greater than 0.05). In conclusion, only one-tenth of outpatients participated in a home-based program, and this allocation was unrelated to geographic considerations. Although patients should continue to be appropriately triaged on the basis of clinical risk to ensure safety, more targeted allocation of patients to home-based services may be warranted. This may optimize the degree of participation and potentially patient outcomes. (Contains 1 figure and 2 tables.) (As Provided).
Anmerkungen	Lippincott Williams & Wilkins. 351 West Camden Street, Baltimore, MD 21201. Tel: 800-638-3030; e-mail: customerservice@lww.com; Web site: http://www.lww.com
Erfasst von	ERIC (Education Resources Information Center), Washington, DC
Update	2017/4/10