Site-specific variation seen in referral rates, even after adjustment for insurance status
TUESDAY, May 12, 2015 (HealthDay News) — Cardiac rehabilitation referral rates are about 60 percent for U.S. patients undergoing percutaneous coronary intervention (PCI), with considerable site-specific variation in rates of referral, according to a study published in the May 19 issue of the Journal of the American College of Cardiology.
Krishna G. Aragam, M.D., from Massachusetts General Hospital in Boston, and colleagues examined the prevalence of and factors associated with referral to cardiac rehabilitation in a national PCI cohort. Data were included for 1,432,399 patients who underwent PCI at 1,310 participating hospitals.
The researchers found that cardiac rehabilitation referral rates were 59.2 percent for the overall population and 66.0 percent for the subgroup of Medicare patients presenting with acute myocardial infarction. Presentation with ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction correlated with elevated odds of referral to cardiac rehabilitation (odds ratios, 2.99 and 1.99, respectively), in multivariable analyses. After adjustment for insurance status, there was significant site-specific variability in referral rates, with more than 25 percent of all hospitals referring fewer than 20 percent of patients.
“These findings highlight the potential need for hospital-level interventions to improve cardiac rehabilitation referral rates after PCI,” the authors write.
Several authors disclosed financial ties to the pharmaceutical industry.
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