Does socially differentiated cardiac rehabilitation affect the use of healthcare services after myocardial infarction? A 10-year follow-up study

OBJECTIVE: To examine the long-term effect of a socially differentiated cardiac rehabilitation (CR) intervention tailored to reduce social inequalities in health regarding use of healthcare services in general practice and hospital among socially vulnerable patients admitted with first-episode myoca...

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Detalles Bibliográficos
Autores principales: Hald, Kathrine, Meillier, Lucette Kirsten, Nielsen, Kirsten M., Breinholt Larsen, Finn, Johansen, Martin Berg, Larsen, Mogens Lytken, Nielsen, Claus Vinther, Christensen, Bo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2019
Materias:
Rehabilitation Medicine
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6830639/
https://www.ncbi.nlm.nih.gov/pubmed/31662379
http://dx.doi.org/10.1136/bmjopen-2019-030807
Descripción
Sumario:OBJECTIVE: To examine the long-term effect of a socially differentiated cardiac rehabilitation (CR) intervention tailored to reduce social inequalities in health regarding use of healthcare services in general practice and hospital among socially vulnerable patients admitted with first-episode myocardial infarction (MI). DESIGN: A prospective cohort study with 10 years’ follow-up. SETTING: Department of cardiology at a university hospital in Denmark between 2000 and 2004. PARTICIPANTS: Patients <70 years admitted with first-episode MI categorised as socially vulnerable (n=208) or non-socially vulnerable (n=171) based on educational level and social network. INTERVENTION: A socially differentiated CR intervention. The intervention consisted of standard CR and expanded CR with focus on cross-sectional collaboration. MAIN OUTCOME MEASURES: Participation in annual chronic care consultations in general practice, contacts to general practice, all-cause hospitalisations and cardiovascular readmissions. RESULTS: At 2-year and 5-year follow-up, socially vulnerable patients receiving expanded CR participated significantly more in annual chronic care consultations (p=0.02 and p<0.01) but at 10-year follow-up, there were no significant differences in annual chronic care consultations (p=0.13). At 10-year follow-up, socially vulnerable patients receiving standard CR had significantly more contacts to general practice (p=0.03). At 10-year follow-up, there were no significant differences in the proportion of socially vulnerable patients receiving expanded CR in the mean number of all-cause hospitalisations and cardiovascular readmissions (p>0.05). CONCLUSIONS: The present study found no persistent association between the socially differentiated CR intervention and use of healthcare services in general practice and hospital in patients admitted with first-episode MI during a 10-year follow-up.

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