Racial Disparities in Access to Cardiac Rehabilitation

OBJECTIVE: This study sought to assess the association between race and referral to cardiac rehabilitation programs. DESIGN: A total of 1933 cardiac patients enrolled in the Cardiac Access Study (n = 9275) who met the criteria selection of the American College of Cardiology Guidelines of eligibility for cardiac rehabilitation were evaluated to determine factors associated with accessing cardiac rehabilitation programs. Referral to a cardiac rehabilitation program among eligible participants was the outcome of interest. Potential factors associated with referral were entered into a logistic regression analysis to determine factors associated with referral. RESULTS: Whites were more likely to be referred for cardiac rehabilitation than were blacks (crude odds ratio OR = 2.52; 95% confidence interval CI = 1.75-3.63). After controlling for age, education, socioeconomic status, and insurance, race was still independently associated with referral for cardiac rehabilitation (OR = 1.81; 95% CI = 1.22-2.68). CONCLUSION: Among those patients who were eligible for cardiac rehabilitation, race is independently associated with the likelihood of referral for cardiac rehabilitation. The decreased utilization of such services in this population could lead to further disparity in cardiac outcomes. Future studies should address ways to eliminate this disparity and increase referral to such services.