Key result
Women's participation in cardiac rehabilitation was overwhelmingly determined by physician referral, which was more likely if the patient had CR insurance.
Why the study?
What accessibility factors predict women's participation in cardiac rehabilitation?
Cross-Sectional (n=370)
Yes
What accessibility factors predict women's participation in cardiac rehabilitation?
Physician referral and insurance coverage are the strongest predictors of women participating in cardiac rehabilitation, highlighting the need for guideline-directed referral and accessible rehabilitation options.
Answers are grounded in this paper and cite their sources.
Referral and insurance strongly associate with women's CR participation; supports access research but should not yet change practice.
The purpose of this study was to identify whether certain factors related to accessibility can predict women's participation in cardiac rehabilitation (CR). This cross-sectional comparative study used a convenience sample of 370 women cardiac patients who were treated and discharged between April 1, 1995, and September 30, 1995. A self-report instrument and medical record reviews were used to collect data at five hospitals and four CR centers in three midsized cities in northeastern Ohio. Differences between participants and nonparticipants were examined on the groups of variables. Logistic regression showed women's participation in CR to be overwhelmingly determined by physician referral (odds ratio [OR] = 0.000), which was more likely to occur if the patient had CR insurance (OR = 0.73). The probability of compliance with a referral in women with CR insurance and no history of coronary heart disease (CHD) was .89; with no insurance and a history of CHD, the probability of participation was .37. Participation was associated with level of education, coronary artery bypass surgery, and available transportation. We recommend the promotion and encouragement of the use of Clinical Practice Guidelines by physicians, and lower cost and more accessible approaches to CR, such as contracting with managed care, home rehabilitation, and community-based programs.
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Eugenia Missik (2001) conducted a cross-sectional in Cardiac disease (n=370). Physician referral vs. No physician referral was evaluated on Participation in cardiac rehabilitation (OR 0.000). Women's participation in cardiac rehabilitation was overwhelmingly determined by physician referral, which was more likely if the patient had CR insurance.
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