Key result
Medicare insurance is linked to ~5.2-fold higher odds of completing cardiac rehabilitation.
Why the study?
Cardiac rehabilitation programs reduce cardiovascular disease risk factors, but participation and completion rates in the US remain poor.
Does Medicare insurance improve completion of a 12-week cardiac rehabilitation program in adults with cardiovascular disease?
Cross-Sectional (n=97)
No
Does Medicare insurance improve completion of a 12-week cardiac rehabilitation program in adults with cardiovascular disease?
Odds Ratio: 5.215 (95% CI 1.897–14.338)
p-value: p=0.001
Social support, female sex, and Medicare coverage are strong predictors of completing cardiac rehabilitation, indicating that targeted interventions addressing financial and psychosocial barriers could improve participation rates.
Medicare was associated with higher cardiac rehabilitation completion; hypothesis-generating and should not yet change practice.
Study objective: Cardiac rehabilitation (CR) programs are effective at reducing cardiovascular disease risk factors, yet programs in the United States (US) have poor participation and completion. The current study evaluates characteristics related to completion and drop-out for CR participants. Design: A cross-sectional study design compared participants who completed the program (finishers) and those did not finish (non-finishers). Variables were compared to determine differences between the dichotomous groups included demographic data, initial six-minute walk test, Zung Depression Index, and Quality of Life Measure (QLM). Logistical regression using variables with differences between groups determined impact on program completion. Setting: Phase two outpatient hospital based cardiac rehabilitation program. Participants: Ninety-seven participants were part of the sample; 61 completed the program, and 36 dropped out. Main outcome measure: Completion of CR. Results: Ninety-seven participants are included; 61 (63 %) were finishers and 36 (37 %) were non-finishers. Finishers were older, had a higher proportion of females and Medicare insurance recipients, had lower depression scores, and reported higher quality of life. Results of the final logistic regression revealed finishers were more likely to have Medicare (odds ratio (OR) = 5.215, confidence interval (CI) 1.897-14.338), be female (OR = 4.597, 95 % CI 1.532-13.795) and have higher QLM Family Sub scores (OR = 1.129, 95 % CI 1.023-1.246). The model correctly classified 71.9 % of cases. Conclusion: The analysis highlights Medicare insurance and family support are associated with program completion. Interventions to increase family and social support, and to provide financial assistance for those with financial burden through lack of insurance or high co-pays may increase cardiac rehabilitation completion rates.
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Regan et al. (2023) conducted a cross-sectional in Cardiovascular disease (phase II cardiac rehabilitation) (n=97). Medicare insurance vs. Other insurance was evaluated on Completion of cardiac rehabilitation (OR 5.215, 95% CI 1.897-14.338, p=0.001). Having Medicare insurance was associated with a more than five-fold increase in the odds of completing cardiac rehabilitation compared to other insurance types (OR 5.215).
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