Cardiac Rehabilitation At A Glance
What are the benefits of cardiac rehabilitation?
- Individuals who attend 36 sessions have a 47% lower risk of death and a 31% lower risk of heart attack than those who attend only 1 session.
- Health systems save $4,950 to $9,200 per person per year of life saved.
- Cardiac rehab participation also reduces hospital readmissions.
Who can benefit but is not being referred?
- Minority status predicts lower referral and participation rates.
- Women, minorities, older people, and those with other medical conditions are under-referred to cardiac rehab.
- One of the best predictors of cardiac rehab referral is whether the eligible person speaks English. Asian Americans are 18 times more likely than white people to speak limited English.
- Black women are 60% less likely than white women to be referred and enroll in cardiac rehab programs.
What improves cardiac rehab referral rates?
- Automatic, systematic referral to cardiac rehab at discharge can help connect eligible people with these programs.
- Strong coordination among inpatient, home health, and outpatient cardiac rehab programs boosts referral rates as well as participation rates and outcomes.
- Patients’ medical teams and families can support and encourage participation in cardiac rehab programs.
- Awareness campaigns should be aimed at people and caregivers.
What are the barriers to cardiac rehabilitation participation and completion?
- Longer wait times following discharge reduce cardiac rehab enrollment.
- For every day a person waits to start cardiac rehab, that person is 1% less likely to enroll.
- People who live outside of metropolitan areas are 30% less likely to participate in cardiac rehab programs.
- People who make more than $75,000 per year are twice as likely to participate as individuals with annual incomes below $15,000.
- Race matters:
How do health systems eliminate barriers to cardiac rehabilitation participation and completion?
- The greatest predictor of participation is the strength of the physician’s recommendation.
- Reduce the interval between hospital discharge and cardiac rehab program orientation by formalizing enrollment practices.
- Support participation in cardiac rehab through community health workers, home health aides, and visiting nurses.
- Design culturally and linguistically appropriate programs.
- Increase use of translation services by physicians and participants.
- Ensure access to services through transportation options and extended hours.
- Where possible, reduce or eliminate financial burden on cardiac rehab participants.
- Diversify cardiac rehab teams.
- Research shows that minority physicians are more likely than white physicians to care for minority, low-income, uninsured, and underserved people.
What other strategies and delivery models could help cardiac rehabilitation uptake?
- Create web-based or home-based programs in rural areas.
- Develop telemedicine-monitored cardiac rehab programs for people unable to access traditional programs.
- For people unable to attend all 36 sessions in a cardiac rehab facility, conduct baseline assessment in a cardiac rehab clinic followed by a nurse-monitored home exercise program.
- Reward eligible people for completing cardiac rehab programs.
- Reward programs with high completion rates.
- Share best practices and lessons learned, including innovations.
A Limited Capacity Limits the Number of Eligible People Served
Complicating the story of program capacity are the geographic variations in the number of
- Cardiac rehab programs
- Eligible people
- Referred and participating people
Although cardiac rehab programs are underutilized, some fear that the existing number of programs would be insufficient to serve all eligible people.
- Cardiac Rehabilitation
Learn about what cardiac rehabilitation involves and why patients who have had a cardiac event should incorporate cardiac rehabilitation into their lives. This page also has a list of tools for clinicians, cardiac rehabilitation teams, and patients, including key publications and guidelines on the subject.
- Cardiac Rehabilitation: Change Package
This change package is a quality improvement tool to help teams from hospitals and cardiac rehabilitation programs put systems and strategies in place that target improved care for more eligible patients. It presents a listing of process improvements that cardiac rehabilitation champions can implement and includes change concepts, change ideas, and tools and resources.
- Cardiac Rehabilitation Communications Kit
This communications kit will equip your organization with resources and messages to spread awareness about the value of cardiac rehabilitation and solutions for increasing participation.
- Million Hearts® #CardiacRehabChat Twitter Moments
Explore resources for improving enrollment, engagement, and adherence shared during our #CardiacRehabChat series.
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