Abstract

Purpose: Determine how rural heart failure patients are referred for outpatient cardiac rehabilitation. This study examined individual and system challenges to cardiac rehabilitation referral.
Methods: This was a prospective study from a single site tertiary care hospital. The primary outcome was to determine how study subjects were referred to cardiac rehabilitation. A secondary outcome was the elicited individual characteristic differences among subjects.
Findings: Sixty-one patients were included in the study, 43 males and 18 females (67 ± 9.37 y). There was a statistically significant difference in who initiated the referral to cardiac rehabilitation depending upon diagnosis code (p<0.001). If CAD or heart surgery was the diagnosis code utilized, mid-level providers initiated the referral; however, if heart failure was the primary, cardiac rehabilitation staff initiated the referral. Secondary findings demonstrated not all heart failure patients were managed by cardiologists, low socioeconomic status, and illiteracy.
Conclusions: A multidisciplinary approach is warranted, especially inpatient cardiac rehabilitation staff, to ensure referral to outpatient cardiac rehabilitation among rural heart failure patients.

Keywords: Health disparities; Health services research; Geography