Bethell Hugh, Lewin Robert, Evans Julia, Turner Sally, Allender Steven, Petersen Sophie
Basingstoke & Alton Cardiac Rehabilitation Centre, Alton, Hampshire, United Kingdom.
J Cardiopulm Rehabil Prev. 2008 Nov-Dec;28(6):386-91. doi: 10.1097/HCR.0b013e31818c3b44.
Cardiac rehabilitation is an effective but underprovided treatment for patients recovering from acute cardiac events. The geographical spread of provision has not been investigated recently in any country. This study aimed to investigate the level of participation in cardiac rehabilitation programs of patients following myocardial infarction or revascularization (eligible patients) and the geographical equity of attendance.
Questionnaire data were collected from all cardiac rehabilitation centers in England for the year 2003/2004. The number of patients attending rehabilitation was compared with eligible patients across the 9 Government Office Regions of England as indicated by Hospital Episode Statistics.
Nationally, 29% of eligible patients attended rehabilitation, while within various regions, the proportion of eligible patients participating in rehabilitation ranged between 14% (95% CI, 13.2-14.3) and 37% (95% CI, 36.6-37.6). Participation also differed significantly by primary cardiac event: myocardial infarction, 25%; percutaneous coronary intervention, 24%; and coronary artery bypass surgery, 66% (P < .001).
The participation rate of eligible patients in cardiac rehabilitation was low in all regions. There were large differences between regions with widely varying incidence of attendance in different parts of the country.
心脏康复对于急性心脏事件后康复的患者而言是一种有效的治疗方法，但目前提供的治疗不足。最近尚未有任何国家对其服务的地理分布情况进行调查。本研究旨在调查心肌梗死或血管重建术后患者（符合条件的患者）参与心脏康复项目的程度以及就诊的地理公平性。
收集了2003/2004年英格兰所有心脏康复中心的问卷调查数据。将参与康复治疗的患者数量与英格兰9个政府办公区域中根据医院事件统计数据显示的符合条件的患者数量进行比较。
在全国范围内，29%的符合条件的患者参与了康复治疗，而在不同区域，参与康复治疗的符合条件的患者比例在14%（95%可信区间，13.2 - 14.3）至37%（95%可信区间，36.6 - 37.6）之间。参与率在主要心脏事件方面也存在显著差异：心肌梗死患者为25%；经皮冠状动脉介入治疗患者为24%；冠状动脉旁路移植术患者为66%（P <.001）。
所有区域中符合条件的患者参与心脏康复的比例都较低。各区域之间存在很大差异，该国不同地区的就诊发生率差异很大。
