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Automatic referral to cardiac rehabilitation.

https://arctichealth.org/en/permalink/ahliterature179514
Source
Med Care. 2004 Jul;42(7):661-9
Publication Type
Article
Date
Jul-2004
Author
Sherry L Grace
Alexandra Evindar
Tabitha N Kung
Patricia E Scholey
Donna E Stewart
Author Affiliation
University Health Network Women's Health Program, Toronto, Ontario, Canada. sherry.grace@uhn.on.ca
Source
Med Care. 2004 Jul;42(7):661-9
Date
Jul-2004
Language
English
Publication Type
Article
Keywords
Aged
Arteriosclerosis - rehabilitation
Causality
Cross-Sectional Studies
Factor Analysis, Statistical
Female
Humans
Logistic Models
Male
Middle Aged
Models, Psychological
Ontario
Patient Acceptance of Health Care - psychology
Referral and Consultation
Socioeconomic Factors
Abstract
Cardiac rehabilitation (CR) remains underused and inconsistently accessed, particularly for women and minorities. This study examined the factors associated with CR enrollment within the context of an automatic referral system through a retrospective chart review plus survey. Through the Behavioral Model of Health Services Utilization, it was postulated that enabling and perceived need factors, but not predisposing factors, would significantly predict patient enrollment.
A random sample of all atherosclerotic heart disease (AHD) patients treated at a tertiary care center (Trillium Health Centre, Ontario, Canada) from April 2001 to May 2002 (n = 501) were mailed a survey using a modified Dillman method (71% response rate).
Predisposing measures consisted of sociodemographics such as age, sex, ethnocultural background, work status, level of education, and income. Enabling factors consisted of barriers and facilitators to CR attendance, exercise benefits and barriers (EBBS), and social support (MOS). Perceived need factors consisted of illness perceptions (IPQ) and body mass index.
Of the 272 participants, 199 (73.2%) attended a CR assessment. Lower denial/minimization, fewer logistical barriers to CR (eg, distance, cost), and lower perceptions of AHD as cyclical or episodic reliably predicted CR enrollment among cardiac patients who were automatically referred.
Because none of the predisposing factors were significant in the final model, this suggests that factors associated with CR enrollment within the context of an automatic referral model relate to enabling factors and perceived need. A prospective controlled evaluation of automatic referral is warranted.
PubMed ID
15213491 View in PubMed
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