Is 70% Achievable? Hospital-Level Variation in Rates of Cardiac Rehabilitation Use Among Medicare Beneficiaries
Authors' conclusion
The treating hospital plays a key role in facilitating CR enrollment after discharge. Fewer than 1% of U.S. hospitals achieved a risk-standardized CR enrollment rate of >70%. Hospitals with cardiac surgery capability care for more than 90% of all CR-eligible patients
Study context
- Population
- Fee-for-Service Medicare beneficiaries aged ≥66 years hospitalised for acute MI, CABG, PCI or heart valve repair/replacement
- Participants
- 264,970 beneficiaries · 3,420 hospitals
- Outcome
- Hospital risk-standardized CR enrollment rate
Methodological detailsnational, hierarchical generalized linear model
- National
- Hierarchical generalized linear model
Main finding
As reported in the abstract
Risk-standardized CR enrollment rate (hospitals with cardiac surgery)
- Median risk-standardized cardiac rehabilitation (CR) enrollment rate
- 22%
- 10th, 90th percentile across hospitals
- 3%, 42%
- Variation across hospitals
- 10-fold
- National hospital median OR
- 2.1
- Hospitals achieving risk-standardized CR enrollment rate >70%
- Fewer than 1%
Observational data: associations, not effects.
Further findings
Hospital factors associated with higher performance
- Midwest location, more hospital beds, directly affiliated CR program, <1 mile to closest CR facility
Original publication
Is 70% Achievable? Hospital-Level Variation in Rates of Cardiac Rehabilitation Use Among Medicare Beneficiaries. JACC Adv. Published 15 November 2024. doi:10.
Summarised from the published abstract; every number is checked against it