Trends in the Use of Cardiac Rehabilitation in Japan Between 2010 and 2017　― An Epidemiological Survey ―

Abstract

Background: Despite the prognostic effectiveness of cardiac rehabilitation (CR) in patients with cardiovascular disease (CVD), it has been underutilized. Understanding the trend of dissemination of CR over the years would help provide a perspective of CR in Japan. Methods and Results:A retrospective epidemiological survey between fiscal years 2010 and 2017 was conducted using the diagnosis procedure combination database (a Japanese administrative database). Data on 2,046,302 patients with CVD from 1,632 hospitals were extracted. The proportion of CR-certified hospitals among hospitals treating patients with CVD increased from 31.6% in 2010 to 56.6% in 2017. Over the same period, the participation rate in inpatient CR (ICR) increased from 18.3% to 39.0%, but the participation rate in outpatient CR (OCR) remained low (from 1.4% to 2.5%). The CR participation rates varied widely according to the main disease group. Approximately 95% of ICR participants did not continue CR after discharge. Conclusions:The number of CR-certified hospitals increased from 2010 to 2017, leading to increased ICR participation across patients with CVD; however, OCR has remained extremely underutilized. Immediate action is urgently required to increase the use of OCR.

Trends and Factors Associated With Cardiac Rehabilitation Participation ― Data From Japanese Nationwide Databases ―

“…Although the number of patients who underwent CR, the total number of CR sessions, and the number of facilities providing CR increased from 2013 to 2017, the participation rate for outpatient CR was lower than that of inpatient CR. The lower participation in outpatient CR was consistent with the findings of another study in Japan; 26 however, the prior study did not suggest methods to address this.…”

A survey of the implementation rate of cardiac rehabilitation for patients with heart disease undergoing device implantation in Japan

“…The results of this study indicated that the implementation rate of CR after device implantation in Japan was 23% ( n = 16 445), and the implementation rate of CR after device implantation in patients with comorbid heart failure was only 32% ( n = 9262). It was reported that the implementation rates of CR after myocardial infarction, heart failure, and cardiac surgery in Japan were 66%, 47%, and 77%, respectively 11 . The implementation rate of CR after device implantation was low compared to these rates.…”

Association between the Big Five personality traits and medication adherence in patients with cardiovascular disease: A cross-sectional study

“…In Japan, inpatient cardiac rehabilitation has become standard care for patients hospitalized for CVD. In 2017, the implementation rates for inpatient cardiac rehabilitation were 76.5%, 65.6%, and 46.9% for patients hospitalized for cardiac surgery, acute coronary syndrome, and heart failure, respectively [ 19 ], which constitute the main population of this study. Health insurance is mandatory in Japan, and cardiac rehabilitation is covered by the Japanese health care system.…”