Department of Cardiology, Hallym University Dongtan Sacred Hospital, Hwaseong, South Korea.
Department of Cardiology, Korea University Anam Hospital, Seoul, South Korea.
PLoS One. 2021 Dec 8;16(12):e0261072. doi: 10.1371/journal.pone.0261072. eCollection 2021.
Cardiac rehabilitation services are mostly underutilized despite the documentation of substantial morbidity and mortality benefits of cardiac rehabilitation post-acute myocardial infarction. To assess the implementation rate and barriers to cardiac rehabilitation in hospitals dealing with acute myocardial infarction in South Korea, between May and July 2016, questionnaires were emailed to cardiology directors of 93 hospitals in South Korea; all hospitals were certified institutes for coronary interventions. The questionnaires included 16 questions on the hospital type, cardiology practice, and implementation of cardiac rehabilitation. The obtained data were categorized into two groups based on the type of the hospital (secondary or tertiary) and statistically analysed. Of the 72 hospitals that responded (response rate of 77%), 39 (54%) were tertiary medical centers and 33 (46%) were secondary medical centers. All hospitals treated acute myocardial infarction patients and performed emergency percutaneous coronary intervention; 79% (57/72) of the hospitals performed coronary artery bypass grafting. However, the rate of implementation of cardiac rehabilitation was low overall (28%, 20/72 hospitals) and even lower in secondary medical centers (12%, 4/33 hospitals) than in tertiary centers (41%, 16/39 hospitals, p = 0.002). The major barriers to cardiac rehabilitation included the lack of staff (59%) and lack of space (33%). In contrast to the wide availability of acute-phase invasive treatment for AMI, the overall implementation of cardiac rehabilitation is extremely poor in South Korea. Considering the established benefits of cardiac rehabilitation in patients with acute myocardial infarction, more administrative support, such as increasing the fee for cardiac rehabilitation services by an appropriate level of health insurance coverage should be warranted.
心脏康复服务的利用率很低，尽管有大量文献记载表明心脏康复对急性心肌梗死后的发病率和死亡率有显著益处。为了评估韩国处理急性心肌梗死的医院实施心脏康复的比率和障碍，我们于 2016 年 5 月至 7 月间向韩国 93 家医院的心脏病学主任发送了电子邮件调查问卷；所有医院都是经认证的冠状动脉介入治疗机构。问卷包括 16 个关于医院类型、心脏病学实践和心脏康复实施情况的问题。根据医院类型（二级或三级）对获得的数据进行分类，并进行统计学分析。在 72 家做出回应的医院中（回应率为 77%），39 家（54%）为三级医疗中心，33 家（46%）为二级医疗中心。所有医院都治疗急性心肌梗死患者并进行紧急经皮冠状动脉介入治疗；79%（57/72）的医院进行冠状动脉旁路移植术。然而，心脏康复的实施率总体较低（28%，20/72 家医院），二级医院（12%，4/33 家医院）的实施率甚至低于三级医院（41%，16/39 家医院，p = 0.002）。心脏康复的主要障碍包括缺乏工作人员（59%）和缺乏空间（33%）。与广泛提供急性介入治疗急性心肌梗死相比，韩国的整体心脏康复实施情况极差。考虑到心脏康复对急性心肌梗死患者的益处已得到证实，应通过适当水平的医疗保险覆盖来增加心脏康复服务的费用等行政支持来确保其实施。
