Surprising Cardiac Rehabilitation Participation Statistics

02/06/08 Treatment Options

Cardiac rehabilitation is an effective tool in recovering from heart illness like myocardial infarctions (MI), better known as heart attacks. The programs speed recovery, stabilize the condition, and limit—or in a growing number of cases—reverse the progression of the disease. The combination of social and physical intervention has demonstrated a better quality of life and a lower risk of death among cardiac patients.

According to the American Heart Association, a cardiac rehabilitation program should consist of:

• Counseling so the patient can understand and manage the disease process
• Beginning an exercise program
• Counseling on nutrition
• Helping the patient modify risk factors such as high blood pressure, smoking, high blood cholesterol, physical inactivity, obesity, and diabetes.
• Providing vocational guidance to enable the patient to return to work
• Supplying information on physical limitations
• Lending emotional support
• Counseling on appropriate use of prescribed medications

The Centers for Disease Control reported in its February 1, 2008 “Weekly Morbidity and Mortality Report” that the United States sustained approximately $277 billion in direct and indirect costs related to heart disease. It is estimated some 865,000 people suffered myocardial infarctions (heart attacks) in the year 2007.

Experts acknowledge that cardiac rehabilitation reduces the recurrence and death rate of participants from cardiovascular disease, improves psychological recovery, and improves clinical outcomes. Such post-MI treatment reduces health care costs by preventing further events. Yet, in a sampling of cardiac patients who responded (in 21 states), only 34.7 percent confirmed they underwent outpatient cardiac rehabilitation.

The study found some interesting corollary findings involving social factors. The more formally educated patients are, the more likely they are to undergo rehabilitation. Income levels were also a significant predictor of the likelihood of participation in a rehabilitation program. People with higher salaries were more likely than lower wage earners to seek out post-myocardial rehab care.  Job status and health insurance were not factors at all. Hispanics were more likely than non-Hispanic Caucasians to receive the services yet they were found to be referred less often (researchers were in a quandary and had no explanation). Understandably, patients living outside a populated area and away from a rehab center were less likely to partake than those in urban areas.

The decision to forego rehabilitation programs following cardiac events does not appear to be one of finance according to the research; but that may be superficial. Most private insurance, Medicare and Medicaid will pick up the costs for a period of time, but not indefinitely. Finding fault with the medical system is unlikely; just about every hospital offers a cardiac rehab program. Hospital personnel are urged to recommend rehab care and teach the benefits of such to every at-risk candidate.  It may be a hurdle to attend a hospital or physician-sponsored program. Perhaps what remains lacking here are the problems of attending a program at least three days a week for an hour or more at a time. Often a patient is unable to drive for the first three weeks (more or less) after a serious cardiac event.  That means patients must depend on a spouse—who may be the sole income producer at the time—for transportation. Then there are fuel costs, parking, and lost work time to consider.

Hospitals should be expected to share cardiac rehabilitation information and teaching with all at-risk patients. Armed with such information, patients’ become responsible for making health their first priority, even with the inconvenience of frequent travel, extra effort, and time commitment a rehabilitation program requires.

Corie Richter is a nurse and physician's assistant who started her career as a health educator. The survivor of a myocardial infarction (heart attack) and partially successful quadruple bypass surgery, she did not let her health challenges hamper her. Neither the limitations of spinal surgery nor of diabetes have deterred her from a mission of service. She now encourages others through writing and speaking engagements to master their disabilities through education and a proactive attitude.