Community-Based Cardiac Rehabilitation Conducted in a Public Health Center in South Korea: A Preliminary Study

Baek, Sora; Ha, Yuncheol; Mok, Jaemin; Park, Hee-Won; Son, Hyo-Rim; Jin, Mi-Suk

doi:10.5535/arm.20084

Cited by 7 publications

(7 citation statements)

References 25 publications

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“…Furthermore, equipment and maintenance of CR facilities and personnel are mandatory. Many of this study’s co-authors have published articles on CR’s status and impact on AMI’s prognosis [ 20 , 21 , 22 , 23 , 24 ]. There has been an increasing acceptance of CR nationwide and an introduction of CR insurance benefits in February 2017.…”

Section: Discussionmentioning

confidence: 99%

Current Status of Cardiac Rehabilitation in the Regional Cardiocerebrovascular Centers in Korea

Kim

Sung

Han

et al. 2021

JCM

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Regional Cardiocerebrovascular Centers (RCCs)—a Korean government initiative—seek to reduce medical gaps across regions, and their cardiac rehabilitation (CR) programs are expected to model post-acute care for the Korean CR program. Accordingly, this study aimed to evaluate the current status of CR programs in the RCCs. We distributed surveys on the CR condition, activity, and barriers to 12 RCCs in different provinces. The results revealed significant gaps in the annual number of acute myocardial infarction admissions, and CR candidates, capacity, and density across the 12 RCCs. The CR capacity (50–500) and density (0.42–7.36) indicated particularly large gaps. Twelve RCCs had the necessary facilities, equipment and personnel for CR assessments and management, with high CR referral (97%) and patient education (78%) rates. However, the inpatient CR exercise training (56%) participation rate was inadequate, with much lower enrollment (47%) and adherence (17%) rates to the outpatient CR program and large differences across centers. Therefore, this study’s results will provide the evidence required to establish special national health strategies to overcome the CR barriers of patient, doctor/hospital, and policy factors for activating Korean CR programs.

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Section: Discussionmentioning

confidence: 99%

Current Status of Cardiac Rehabilitation in the Regional Cardiocerebrovascular Centers in Korea

Kim

Sung

Han

et al. 2021

JCM

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“…Evidence from other countries also suggest the utility of community-based CR models may be effective in improving participation within specific communities, although more research is needed to evaluate these models within the United States. 22,23 The relationship between community-level distress and access to CR and subsequent participation is more nuanced. On one hand, patients in distressed communities were more likely to have CR facilities within their zip codes and yet also have worse rates of participation.…”

Section: Discussionmentioning

confidence: 99%

Relationship Between Community-Level Distress and Cardiac Rehabilitation Participation, Facility Access, and Clinical Outcomes After Inpatient Coronary Revascularization

Thompson,

Hou,

Stewart

et al. 2023

Circ: Cardiovascular Quality and Outcomes

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Background: Although disparities in cardiac rehabilitation (CR) participation are well documented, the role of community-level distress is poorly understood. This study evaluated the relationship between community-level distress and CR participation, access to CR facilities, and clinical outcomes. Methods: A retrospective cohort study was conducted on a 100% sample of Medicare beneficiaries undergoing inpatient coronary revascularization between July 2016 and December 2018. Community-level distress was defined using the Distressed Community Index quintile at the beneficiary zip code level, with the first and fifth quintiles representing prosperous and distressed communities, respectively. Outpatient claims were used to identify any CR use within 1 year of discharge. Beneficiary and CR facility zip codes were used to describe access to CR facilities. Adjusted logistic regression models evaluated the association between Distressed Community Index quintiles, CR use, and clinical outcomes, including one-year mortality, all-cause hospitalization, and acute myocardial infarction hospitalization. Results: A total of 414 730 beneficiaries were identified, with 96 929 (23.4%) located in the first and 67 900 (16.4%) in the fifth quintiles, respectively. Any CR use was lower for beneficiaries in distressed compared with prosperous communities (26.0% versus 46.1%, P <0.001), which was significant after multivariable adjustment (odds ratio, 0.41 [95% CI, 0.40–0.42]). A total of 98 458 (23.7%) beneficiaries had a CR facility within their zip code, which increased from 16.3% in prosperous communities to 26.6% in distressed communities. Any CR use was associated with absolute reductions in mortality (−6.8% [95% CI, −7.0% to −6.7%]), all-cause hospitalization (−5.9% [95% CI, −6.3% to −5.6%]), and acute myocardial infarction hospitalization (−1.3% [95% CI, −1.5% to −1.1%]), which were similar across each Distressed Community Index quintiles. Conclusions: Although community-level distress was associated with lower CR participation, the clinical benefits were universally received. Addressing barriers to CR in distressed communities should be considered a significant priority to improve survival after coronary revascularization and reduce disparities.

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“… 25 Therefore, utilizing the health-related resources of the community can facilitate CVD patients’ participation in CR in nearby institutions at a convenient time. 26 For patients with high risk of heart attack during exercise, such as those with advanced heart failure, complex dysrhythmia, and complicated myocardial infarction, exercise training in specialized hospitals with a professional response system should be considered. However, for patients classified as having low to moderate risk of a cardiac attack during exercise as determined by a cardiopulmonary exercise test, CR can be safely provided in regional hospitals or clinics that do not perform PCI.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Current Resources Available for Community-Based Cardiac Rehabilitation in Korea: A Nationwide Survey Study

et al. 2022

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Background In Korea, the actual distribution of cardiac rehabilitation (CR) to the clinical field is insufficient due to the many barriers for cardiovascular patients to participate in CR. Community-based CR is a useful alternative to overcome these obstacles. Through a nationwide survey, we investigated the possibility of regional medical and public health management institutes which can be in charge of community-based CR in Korea. Methods The questionnaires on recognition of CR and current available resources in health-related institutions were developed with reference to the CR evaluation tools of York University and the International Council of Cardiovascular Prevention and Rehabilitation. The questionnaires were sent to regional public and private medical institutions and public health management institutions. Results In total, 2,267 questionnaires were sent to 1,186 institutions. There were 241 and 242 responses from 173 and 179 regional private and public medical institutions, respectively. And a total of 244 responses were gathered from 180 public health management institutions. Although many institutions were equipped with the necessary facilities for exercise training, there were few patient-monitoring systems during exercise. Most institutions were aware of the need for CR, but were burdened with the cost of establishing personnel and facilities to operate CR. Conclusion Most regional medical, and public health management institutions in Korea are unprepared for the implementation of community-based CR programs. To encourage the utilization of such, there should be efforts to establish a national consensus.

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Community-Based Cardiac Rehabilitation Conducted in a Public Health Center in South Korea: A Preliminary Study

Cited by 7 publications

References 25 publications

Current Status of Cardiac Rehabilitation in the Regional Cardiocerebrovascular Centers in Korea

Current Status of Cardiac Rehabilitation in the Regional Cardiocerebrovascular Centers in Korea

Relationship Between Community-Level Distress and Cardiac Rehabilitation Participation, Facility Access, and Clinical Outcomes After Inpatient Coronary Revascularization

Evaluation of Current Resources Available for Community-Based Cardiac Rehabilitation in Korea: A Nationwide Survey Study

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