Key result
Inpatient cardiac rehab for AHF reaches ~55% in Japan while outpatient participation remains low.
Why the study?
Although cardiac rehabilitation is crucial for heart failure secondary prevention, trends in inpatient and outpatient participation following acute heart failure in Japan had not been described.
What are the trends in inpatient and outpatient cardiac rehabilitation utilization among patients admitted for acute heart failure in Japan?
Cohort (n=88,052)
What are the trends in inpatient and outpatient cardiac rehabilitation utilization among patients admitted for acute heart failure in Japan?
Inpatient cardiac rehabilitation participation for acute heart failure in Japan increased significantly from 2009 to 2020, but outpatient participation remains vastly underutilized.
Answers are grounded in this paper and cite their sources.
Inpatient CR gains contrast with persistent outpatient underuse; leaves open targeted strategies to boost overall participation in acute HF.
OBJECTIVES: To describe inpatient and outpatient cardiac rehabilitation (CR) utilization patterns over time and by subgroups among patients admitted for acute heart failure (AHF) in Japan. BACKGROUND: Cardiac rehabilitation (CR) is a crucial secondary prevention strategy for patients with heart failure. While the number of older patients with AHF continues to rise, trends in inpatient and outpatient CR participation following AHF in Japan have not been described to date. METHODS: We conducted a retrospective cohort study of adult patients hospitalized for AHF in Japan between April 2008 and December 2020. Using data from the Medical Data Vision database, we measured trends in inpatient and outpatient CR participation following AHF. Descriptive analyses and summary statistics for AHF patients by CR participation status were reported. RESULTS: The analytic cohort included 88,052 patients. Among these patients, 37,810 (42.9%) participated in inpatient and/or outpatient CR. Of those, 36,431 (96.4%) participated in inpatient CR only and 1,277 (3.4%) participated in both inpatient and outpatient CR. Rates of inpatient CR rose more than 6-fold over the study period, from 9% in 2009 to 55% in 2020, whereas rates of outpatient CR were consistently low. CONCLUSIONS: The rate of inpatient CR participation among AHF patients in Japan rose dramatically over a 12-year period, whereas outpatient CR following AHF was vastly underutilized. Further study is needed to assess the clinical effectiveness of inpatient CR and to create infrastructure and incentives to support and encourage outpatient CR.
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Kim et al. (2023) conducted a cohort in Acute heart failure (n=88,052). Cardiac rehabilitation (inpatient and outpatient) was evaluated on Trends in inpatient and outpatient cardiac rehabilitation participation. Inpatient cardiac rehabilitation participation among acute heart failure patients in Japan rose from 9% in 2009 to 55% in 2020, whereas outpatient participation remained consistently low.
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