Prince George's County Health Department, Largo, Maryland (Mss Murphy and Stokes and Dr Amuta); Prince George's County Health Department, Largo, and Kennedy Krieger Institute and Johns Hopkins University School of Medicine, Baltimore, Maryland (Dr Carter); Independent Consultant, Washington, District of Columbia (Dr Thomas); Totally Linking Care in Maryland, Leonardtown, Maryland (Ms Thomas); Health Quality Innovators, Richmond, Virginia (Ms Lichty-Hess); and Johns Hopkins Center for Health Disparities Solutions, Baltimore, Maryland (Drs Zare and Gaskin).
J Public Health Manag Pract. 2024;30:S137-S140. doi: 10.1097/PHH.0000000000001945. Epub 2024 Jul 22.
The Prince George's County Health Department encountered several challenges to increasing access to cardiac rehabilitation (CR) services among disadvantaged populations. They include excessive patient out-of-pocket costs; requirements that CR orders must be signed by a physician; provider reluctance to refer patients to CR, with most primary care providers preferring to refer clients to cardiologists for the latter to determine whether the patient needs CR referral; limited availability of CR programs; and difficulty identifying patients eligible for CR services. Discussions with other local health departments and public health practitioners indicate that these challenges are not unique to Maryland but are indicative of policy and system barriers that prevent the optimal delivery of cardiovascular health services. This practice report documents the challenges and the Prince George's County Health Department's efforts to resolve them and provides recommendations for decision-makers seeking to make CR programs more accessible to disadvantaged populations.
乔治王子县卫生局在增加弱势人群获得心脏康复（CR）服务方面遇到了一些挑战。这些挑战包括：过高的患者自付费用；要求 CR 医嘱必须由医生签署；医疗机构不愿将患者转介到 CR，大多数初级保健提供者更愿意将客户转介给心脏病专家，由后者来确定患者是否需要 CR 转介；CR 项目的可用性有限；以及确定符合 CR 服务条件的患者存在困难。与其他地方卫生部门和公共卫生从业者的讨论表明，这些挑战并非仅在马里兰州存在，而是表明存在政策和制度障碍，阻碍了心血管健康服务的最佳提供。本实践报告记录了这些挑战以及乔治王子县卫生局为解决这些挑战所做的努力，并为寻求使 CR 项目更容易为弱势群体所接受的决策者提供了建议。
