Sawamura Akinori, Kanaoka Koshiro, Motokawa Tetsufumi, Katano Satoshi, Kono Yuji, Ohya Yusuke, Miura Shin-Ichiro, Fukuma Nagaharu, Makita Shigeru, Miyamoto Yoshihiro, Izawa Hideo
Department of Cardiology, Ichinomiya Municipal Hospital Aichi Japan.
Department of Medical and Health Information Management, National Cerebral and Cardiovascular Center Osaka Japan.
Circ Rep. 2024 Sep 5;6(10):424-429. doi: 10.1253/circrep.CR-24-0048. eCollection 2024 Oct 10.
The influence of various regional backgrounds on participation in cardiac rehabilitation (CR) remains underexplored. We investigated the regional characteristics that potentially promote CR participation.
This was a nationwide cross-sectional cohort study using the Japanese Registry of All Cardiac and Vascular Diseases and the Diagnosis Procedure Combination. This study included a cohort of 2.7 million inpatients hospitalized between April 2012 and March 2021. The CR participation rate for each hospital was calculated as the percentage of eligible patients who underwent CR during their admission. Among all hospitals, those that do not perform CR were defined as No-CR hospitals. The remaining hospitals were categorized into High- and Low-CR hospitals based on the median level of the CR participation rate (41.5%). High-CR hospitals had significantly smaller medical service areas (P<0.0001), a higher number of physicians per population (P<0.0001), higher air temperature (P=0.02), and fewer primary industry workers (P=0.005) than the other 2 groups. Logistic regression analyses revealed that a lower consumer price index was a significant regional factor that characterized High-CR hospitals, and a lower population aged ≥65 years was a factor approaching significance that characterized the region where High-CR hospitals are located.
High-CR hospitals were found in regions with a lower consumer price index and a trend towards a lower population aged ≥65 years.
各种地区背景对心脏康复（CR）参与率的影响仍未得到充分研究。我们调查了可能促进CR参与的地区特征。
这是一项全国性横断面队列研究，使用了日本全心血管疾病登记处和诊断程序组合。本研究纳入了2012年4月至2021年3月期间住院的270万住院患者队列。每家医院的CR参与率计算为入院期间接受CR的符合条件患者的百分比。在所有医院中，未开展CR的医院定义为无CR医院。其余医院根据CR参与率的中位数水平（41.5%）分为高CR医院和低CR医院。与其他两组相比，高CR医院的医疗服务区域显著更小（P<0.0001），人均医生数量更多（P<0.0001），气温更高（P=0.02），第一产业工人更少（P=0.005）。逻辑回归分析显示，较低的消费者价格指数是高CR医院的一个显著区域特征因素，较低的65岁及以上人口是高CR医院所在地区的一个接近显著的特征因素。
在消费者价格指数较低且65岁及以上人口呈下降趋势的地区发现了高CR医院。
