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Social inequality and barriers to cardiac rehabilitation in the rehab-north register: a cross-sectional study of 5455 men and women

Session Poster session 3

Speaker Christina Graversen

Event : ESC Congress 2017

  • Topic : preventive cardiology
  • Sub-topic : Risk Factors and Prevention
  • Session type : Poster Session

Authors : CB Graversen (Aalborg,DK), R Eichhorst (Aalborg,DK), L Ravn (Aalborg,DK), SSR Christiansen (Aalborg,DK), MB Johansen (Aalborg,DK), ML Larsen (Aalborg,DK)

Authors:
C.B. Graversen1 , R. Eichhorst1 , L. Ravn1 , S.S.R. Christiansen1 , M.B. Johansen1 , M.L. Larsen1 , 1Aalborg University Hospital, Cardiology - Aalborg - Denmark ,

Topic(s):
Prevention - Interventions and outcomes

Citation:
European Heart Journal ( 2017 ) 38 ( Supplement ), 524

Background: Social inequality may indirectly influence a patient's chance of referral to a cardiac rehabilitation (CR) or the patient's wish to participate in such. The Rehab-North register investigates the impact of socioeconomic status acts as a barrier to the referral process to cardiac rehabilitations referral.

Methods: The Rehab-North Register, a cross-sectional study, enrolled 5455 patients hospitalised at Aalborg University Hospital with myocardial infarction (MI) during 2011–2014. Patients diagnosed with STEMI and complicated NSTEMI were sent to specialised CR, whereas patients with uncomplicated NSTEMI and UAP were sent to community-based CR. Socioeconomic information was obtained from statistical registers from Statistic Denmark and analysed using logistic regression.

Results: The results are shown in table 1. Patients being retired, low educated, and/or with an annual gross income <27.000 Euro/yr were significantly less informed about cardiac rehabilitation programmes and less willing to participate in CR. Patients being retired, low educated and/or with a gross income <27.500 Euro/yr were significantly more often referred to community-based CR.

Conclusion: Patients with low socioeconomic status received less information about and were less willing to participate in cardiac rehabilitation. Knowledge about the impact of social inequality may help in tailoring a better approach in the referral process to CR.

Table 1, Impact of social inequality on referral to cardiac rehabilitation
Informed, n=3365Wish to participate, n=2062Specialised CR, n=691
(OR (95%-CI))(OR (95%-CI))(OR (95%-CI))
Mean age (years, SD)65.5 (10.7)64.4 (10.8)60.5 (11.0)
Labour status (n, %)
  Employed111
  Unemployed0.79 (0.56–1.11)1.18 (0.77–1.80)1.01 (0.63–1.60)
  Retired0.52 (0.46–0.59)0.68 (0.58–0.78)0.41 (0.34–0.49)
Educational level (n, %)
  Low111
  Medium1.32 (1.18–1.49)1.19 (1.02–1.39)1.29 (1.06–1.58)
  Higher1.53 (1.28–1.84)1.13 (0.91–1.40)1.73 (1.31–2.28)
Gross income per year, Euro (n, %)
  <13,5000,87 (0,60–1,26)1.25 (0.74–2.12)1.33 (0.66–2.67)
  13,500–27,000111
  27,000–40,50001,37 (1,20–1,57)1.37 (1.15–1.63)1.25 (0.98–1.59)
  >40.5002,00 (1,75–2,31)1.44 (1.22–1.71)2.49 (2.00–3.10)

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