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Social inequality persists in referral to cardiac rehabilitation

Session Poster session 2

Speaker Christina Graversen

Event : ESC Preventive Cardiology (Formerly EuroPrevent) 2016

  • Topic : preventive cardiology
  • Sub-topic : Cardiovascular Rehabilitation
  • Session type : Poster Session

Authors : CBG Christina Boesgaard Graversen (Aalborg,DK), MLL Mogens Lytken Larsen (Aalborg,DK)

CBG Christina Boesgaard Graversen1 , MLL Mogens Lytken Larsen1 , 1Aalborg University Hospital, Cardiology - Aalborg - Denmark ,

On behalf: REHAB-NORTH

European Journal of Preventive Cardiology ( September 2016 ) 23 ( Supplement 1 ), S33

Purpose: Considerable evidence support the beneficial effect of cardiac rehabilitation (CR) but social status influences referral and attendance to such programmes. We sought to identify if referral to CR has changed after years of intensified focus on social inequality.
Methods: This cross-sectional study included 1919 hospitalised patients with a myocardial infarction in the period of 2011-14. A special questionnaire clarified if the patient received information about CR, if the patient wanted CR (if not, reason for this choice), and to which CR programme the patient was scheduled (figure 1). Chi square test was used to explore the relationship between educational level and referral to CR.
Results: A total of 890 patients were referred to out-hospital CR and 418 patients to in-hospital CR programme. The analysis found general trends in low educational level being less likely to receive in-hospital CR compared  with high- (OR=0.60, p=0.001) or medium education level (OR=0.76, p=0.05). Further, referral to out-hospital CR was more likely with low educational level compared with high educational level (OR=1.57, p<0.001).
Conclusion: Referral to CR is still influenced by social inequality despite increased focus on the matter. It is of great importance to clarify why this pattern persists. Further, future studies are needed to understand why patients are not referred (barriers by professionals) and why patients do not wish to participate (patient barriers).

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