Inequality Across the Cardiac Rehabilitation Trajectory in Denmark: Investigating Key Sociodemographic and Health-Related Drivers

Aim Investigate the key sociodemographic and health-related drivers of inequality across the cardiac rehabilitation (CR) trajectory, to advance understanding of the underlying factors shaping inequality in CR. Methods We conducted a survey- and register-based cohort study that combined data from a nationwide patient survey and Danish registries. A total of 5,375 (53.8%) individuals diagnosed with cardiovascular disease (CVD) in 2018 responded to survey. Dominance analyses and multivariable logistic regression analyses were performed to examine the association of multiple sociodemographic and health-related factors on being offered, accepting, and participating in CR. Results The key drivers of inequality in being offered CR were age, type of CVD, and occupational status, with older adults (≥76 years) and those with ischemic heart disease (IHD) significantly less likely to receive an offer. Municipality group, educational level and family income were the key drivers of inequality in accepting CR, with individuals of a low family income significantly less likely to accept. Municipality group, country of birth and age were the key drivers of inequality for participating in CR, with those residing in rural municipalities and individuals born in a non-Western country significantly less likely to participate. Conclusion Age, type of CVD, municipality group, socioeconomic factors (occupational status, education level and family income) and country of birth was identified as the key drivers of inequality across the CR trajectory, with their influence varying at each CR phase. The results of this study can inform the development of future person-centred care (PCC) strategies to ensure more equitable CR.