Utilisation of outpatient cardiac rehabilitation in Queensland

Med J Aust. 2003 Oct 6;179(7):341-5. doi: 10.5694/j.1326-5377.2003.tb05588.x.


Objectives: To determine patient participation rates in outpatient cardiac rehabilitation (OCR) programs; ascertain the barriers to participation; and evaluate the quality of OCR programs.

Design and setting: Retrospective cohort study of patient separations from selected public and private Queensland hospitals; questionnaire survey of hospitals and all registered OCR programs.

Participants: Patients discharged with cardiac diagnoses between 1 July 1999 and 30 June 2000 from 31 hospitals (24 public; 7 private).

Main outcome measures: Rates of referral of hospitalised patients to OCR programs; rates of program attendance and completion; barriers to OCR referral and attendance.

Results: 15 186 patients were discharged with cardiac diagnoses from participating hospitals, of whom 4346 (29%) were referred to an OCR program after discharge, compared with an estimated 59% (8895/15 186) of patients who were eligible for such a program. Proportionately more patients were referred from secondary (38% [1720/4500]) and private (52% [2116/4031]; P < 0.001) hospitals than from tertiary (25% [2626/10 686]) and public (20% [2230/11 155]) hospitals. Patients undergoing coronary revascularisation procedures comprised 35% of discharges, but accounted for 56% of all program attendances. Fewer than a third of all referred patients completed OCR programs, and only 39% of available OCR program places were fully utilised. Catchment populations of programs with unused places had excess coronary mortality.

Conclusion: There is significant underutilisation of facility-based OCR programs in Queensland. Procedures are required for identifying and referring eligible patients to existing programs and improving program compliance. Alternative OCR models are also required.

MeSH terms

  • Aged
  • Ambulatory Care / statistics & numerical data
  • Angioplasty, Balloon, Coronary / rehabilitation*
  • Coronary Artery Bypass / rehabilitation*
  • Exercise Therapy / statistics & numerical data*
  • Health Services Accessibility
  • Hospitals, Private / statistics & numerical data
  • Hospitals, Public / statistics & numerical data
  • Humans
  • Myocardial Infarction / rehabilitation*
  • Patient Compliance / statistics & numerical data*
  • Queensland
  • Referral and Consultation / statistics & numerical data*
  • Retrospective Studies