Access to cardiac rehabilitation does not equate to attendance

作者：Clark Robyn A^*; Coffee Neil; Turner Dorothy; Eckert Kerena A; van Gaans Deborah; Wilkinson David; Stewart Simon; Tonkin Andrew M

来源：European Journal of Cardiovascular Nursing, 2014, 13(3): 235-242.

DOI：10.1177/1474515113486376

• geographic information systems
• secondary prevention
• Access

Background/Aims: Timely access to appropriate cardiac care is critical for optimizing positive outcomes after a cardiac event. Attendance at cardiac rehabilitation (CR) remains less than optimal (10%-30%). Our aim was to derive an objective, comparable, geographic measure reflecting access to cardiac services after a cardiac event in Australia. Methods: An expert panel defined a single patient care pathway and a hierarchy of the minimum health services for CR and secondary prevention. Using geographic information systems a numeric/alpha index was modelled to describe access before and after a cardiac event. The aftercare phase was modelled into five alphabetical categories: from category A (access to medical service, pharmacy, CR, pathology within 1 h) to category E (no services available within 1 h). Results: Approximately 96% or 19 million people lived within 1 h of the four basic services to support CR and secondary prevention, including 96% of older Australians and 75% of the indigenous population. Conversely, 14% (64,000) indigenous people resided in population locations that had poor access to health services that support CR after a cardiac event. Conclusion: Results demonstrated that the majority of Australians had excellent %26apos;geographic%26apos; access to services to support CR and secondary prevention. Therefore, it appears that it is not the distance to services that affects attendance. Our %26apos;geographic%26apos; lens has identified that more research on socioeconomic, sociological or psychological aspects to attendance is needed.

• 出版日期2014-6