P631Socioeconomic status; how does it influence referral to cardiac rehabilitation after acute myocardial infarction?

Abstract Background The number of patients with low socioeconomic status who are referred to cardiac rehabilitation (CR) has been documented to be relative lower than patients with high SES among all patients hospitalised with acute myocardial infarction (AMI). Purpose The aims of this study were to...

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Published in:European heart journal 2019-10, Vol.40 (Supplement_1)
Main Authors: Graversen, C B, Johansen, M B, Johnsen, S P, Riahi, S, Holmberg, T, Larsen, M L
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description Abstract Background The number of patients with low socioeconomic status who are referred to cardiac rehabilitation (CR) has been documented to be relative lower than patients with high SES among all patients hospitalised with acute myocardial infarction (AMI). Purpose The aims of this study were to evaluate the referral process to CR and how it is influenced by socioeconomic variables. Methods In 2011–2014, 1229 patients were hospitalised with AMI at Department of Cardiology of our University Hospital, Denmark. All were evaluated for participation to CR. Socioeconomic status was measured by personal income, educational level, marital status, and employment and obtained from national registers. Multiple logistic regression assessed socioeconomic determinants in three phases of the referral process to CR: 1. information about CR, 2. wish to participate in CR, and 3. referral to specialiced- or municipality-based CR. All analyses were adjusted for sex, age, and comorbidities. Results A total of 1123 (91.4%) patients received information regarding CR. Of these, 854 (69.5%) patients wished to participate in the programme. Income was the most important socioeconomic variable when looking at who were informed about CR (OR 2.17, 95%-CI: 1.0- 4.64) and who wished to participate in CR (OR 1.55, 95%-CI: 1.02–2.35). Characteristics of study participants Characteristics All participants STEMI NSTEMI UAP n=1229 n=402 n=711 n=116 Male (n, %) 907 (73.8) 322 (80.1) 503 (70.7) 82 (70.7) Age Group (yrs)  
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Purpose The aims of this study were to evaluate the referral process to CR and how it is influenced by socioeconomic variables. Methods In 2011–2014, 1229 patients were hospitalised with AMI at Department of Cardiology of our University Hospital, Denmark. All were evaluated for participation to CR. Socioeconomic status was measured by personal income, educational level, marital status, and employment and obtained from national registers. Multiple logistic regression assessed socioeconomic determinants in three phases of the referral process to CR: 1. information about CR, 2. wish to participate in CR, and 3. referral to specialiced- or municipality-based CR. All analyses were adjusted for sex, age, and comorbidities. Results A total of 1123 (91.4%) patients received information regarding CR. Of these, 854 (69.5%) patients wished to participate in the programme. Income was the most important socioeconomic variable when looking at who were informed about CR (OR 2.17, 95%-CI: 1.0- 4.64) and who wished to participate in CR (OR 1.55, 95%-CI: 1.02–2.35). Characteristics of study participants Characteristics All participants STEMI NSTEMI UAP n=1229 n=402 n=711 n=116 Male (n, %) 907 (73.8) 322 (80.1) 503 (70.7) 82 (70.7) Age Group (yrs)   &lt;65 591 (48.1) 227 (56.5) 308 (43.3) 56 (48.3)   65–74 371 (30.2) 116 (28.9) 215 (30.2) 40 (34.5)   ≥75 267 (21.7) 59 (14.7) 188 (26.4) 20 (17.2) Baseline Comorbidity   Hypertension 241 (19.6) 62 (15.4) 148 (20.8) 31 (26.7)   Diabetes 14 (1.1) &lt;5 (&lt;1) 8 (1.1) &lt;5 (&lt;1) Charlson Comorbidity Index   Low (0 points) 1088 (88.5) 358 (89.1) 630 (88.6) 100 (86.2)   Moderate/High (&gt;0) 141 (11.5) 44 (10.9) 81 (11.4) 16 (13.8) Civil status (n, %)   Married/Partnership 793 (64.5) 253 (62.9) 449 (63.2) 91 (78.4)   Divorced/Unmarried/Widow 436 (35.5) 149 (37.1) 262 (36.8) 25 (21.6) Occupational status (n, %)   Employed 479 (39.0) 195 (48.5) 240 (33.8) 44 (37.9)   Unemployed/Retired 750 (61.0) 207 (51.5) 471 (66.2) 72 (62.1) Educational status (n, %)   Low 516 (42.0) 144 (35.8) 322 (45.3) 50 (43.1)   Medium 539 (43.9) 201 (50.0) 293 (41.2) 45 (38.8)   High 174 (14.2) 57 (14.2) 96 (13.5) 21 (18.1) Gross income, tertile (n, %)   Low 405 (33.0) 113 (28.1) 251 (35.3) 41 (35.3)   Medium 406 (33.0) 124 (30.8) 247 (34.7) 35 (30.2)   High 418 (34.0) 165 (41.0) 213 (30.0) 40 (34.5) STEMI: ST-elevated myocardial infarction; NSTEMI: non-ST-elevated myocardial infarction; UAP: unstable angina pectoris. Conclusion Two out of three patients received referral to CR. However, higher income was proportional with the likelihood of receiving information about CR and willingness to participate in the programme. Acknowledgement/Funding the Danish Heart Foundation</description><identifier>ISSN: 0195-668X</identifier><identifier>EISSN: 1522-9645</identifier><identifier>DOI: 10.1093/eurheartj/ehz747.0239</identifier><language>eng</language><publisher>Oxford University Press</publisher><ispartof>European heart journal, 2019-10, Vol.40 (Supplement_1)</ispartof><rights>Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2019. For permissions, please email: journals.permissions@oup.com. 2019</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27898,27899</link.rule.ids></links><search><creatorcontrib>Graversen, C B</creatorcontrib><creatorcontrib>Johansen, M B</creatorcontrib><creatorcontrib>Johnsen, S P</creatorcontrib><creatorcontrib>Riahi, S</creatorcontrib><creatorcontrib>Holmberg, T</creatorcontrib><creatorcontrib>Larsen, M L</creatorcontrib><title>P631Socioeconomic status; how does it influence referral to cardiac rehabilitation after acute myocardial infarction?</title><title>European heart journal</title><description>Abstract Background The number of patients with low socioeconomic status who are referred to cardiac rehabilitation (CR) has been documented to be relative lower than patients with high SES among all patients hospitalised with acute myocardial infarction (AMI). Purpose The aims of this study were to evaluate the referral process to CR and how it is influenced by socioeconomic variables. Methods In 2011–2014, 1229 patients were hospitalised with AMI at Department of Cardiology of our University Hospital, Denmark. All were evaluated for participation to CR. Socioeconomic status was measured by personal income, educational level, marital status, and employment and obtained from national registers. Multiple logistic regression assessed socioeconomic determinants in three phases of the referral process to CR: 1. information about CR, 2. wish to participate in CR, and 3. referral to specialiced- or municipality-based CR. All analyses were adjusted for sex, age, and comorbidities. Results A total of 1123 (91.4%) patients received information regarding CR. Of these, 854 (69.5%) patients wished to participate in the programme. Income was the most important socioeconomic variable when looking at who were informed about CR (OR 2.17, 95%-CI: 1.0- 4.64) and who wished to participate in CR (OR 1.55, 95%-CI: 1.02–2.35). Characteristics of study participants Characteristics All participants STEMI NSTEMI UAP n=1229 n=402 n=711 n=116 Male (n, %) 907 (73.8) 322 (80.1) 503 (70.7) 82 (70.7) Age Group (yrs)   &lt;65 591 (48.1) 227 (56.5) 308 (43.3) 56 (48.3)   65–74 371 (30.2) 116 (28.9) 215 (30.2) 40 (34.5)   ≥75 267 (21.7) 59 (14.7) 188 (26.4) 20 (17.2) Baseline Comorbidity   Hypertension 241 (19.6) 62 (15.4) 148 (20.8) 31 (26.7)   Diabetes 14 (1.1) &lt;5 (&lt;1) 8 (1.1) &lt;5 (&lt;1) Charlson Comorbidity Index   Low (0 points) 1088 (88.5) 358 (89.1) 630 (88.6) 100 (86.2)   Moderate/High (&gt;0) 141 (11.5) 44 (10.9) 81 (11.4) 16 (13.8) Civil status (n, %)   Married/Partnership 793 (64.5) 253 (62.9) 449 (63.2) 91 (78.4)   Divorced/Unmarried/Widow 436 (35.5) 149 (37.1) 262 (36.8) 25 (21.6) Occupational status (n, %)   Employed 479 (39.0) 195 (48.5) 240 (33.8) 44 (37.9)   Unemployed/Retired 750 (61.0) 207 (51.5) 471 (66.2) 72 (62.1) Educational status (n, %)   Low 516 (42.0) 144 (35.8) 322 (45.3) 50 (43.1)   Medium 539 (43.9) 201 (50.0) 293 (41.2) 45 (38.8)   High 174 (14.2) 57 (14.2) 96 (13.5) 21 (18.1) Gross income, tertile (n, %)   Low 405 (33.0) 113 (28.1) 251 (35.3) 41 (35.3)   Medium 406 (33.0) 124 (30.8) 247 (34.7) 35 (30.2)   High 418 (34.0) 165 (41.0) 213 (30.0) 40 (34.5) STEMI: ST-elevated myocardial infarction; NSTEMI: non-ST-elevated myocardial infarction; UAP: unstable angina pectoris. Conclusion Two out of three patients received referral to CR. However, higher income was proportional with the likelihood of receiving information about CR and willingness to participate in the programme. Acknowledgement/Funding the Danish Heart Foundation</description><issn>0195-668X</issn><issn>1522-9645</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNqNkM1KxDAUhYMoOI4-gpAX6EySNn-4EBn8gwEFZ-GupOkNzdBphqRFxqe3peLa1YXD-Q6XD6FbSlaU6HwNQ2zAxH6_huZbFnJFWK7P0IJyxjItCn6OFoRqngmhPi_RVUp7QogSVCzQ8C5y-hGsD2BDFw7e4tSbfkh3uAlfuA6QsO-x71w7QGcBR3AQo2lxH7A1sfbGjlljKt_6EfShw8b1ELGxQw_4cApzq502TLRT4_4aXTjTJrj5vUu0e3rcbV6y7dvz6-Zhm1kldaZUwW2tpBAAilNRs5xIzampDJNOMVlrUJV0FSOKWq0YSAa1rBwvnJE1z5eIz7M2hpTGz8tj9AcTTyUl5aSu_FNXzurKSd3IkZkLw_GfyA9IEHlS</recordid><startdate>20191001</startdate><enddate>20191001</enddate><creator>Graversen, C B</creator><creator>Johansen, M B</creator><creator>Johnsen, S P</creator><creator>Riahi, S</creator><creator>Holmberg, T</creator><creator>Larsen, M L</creator><general>Oxford University Press</general><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20191001</creationdate><title>P631Socioeconomic status; how does it influence referral to cardiac rehabilitation after acute myocardial infarction?</title><author>Graversen, C B ; Johansen, M B ; Johnsen, S P ; Riahi, S ; Holmberg, T ; Larsen, M L</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c879-8845cd8766ee8516d2307951aba27f827d9e8b7fb2081c982e72ed7bf54fa7d53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Graversen, C B</creatorcontrib><creatorcontrib>Johansen, M B</creatorcontrib><creatorcontrib>Johnsen, S P</creatorcontrib><creatorcontrib>Riahi, S</creatorcontrib><creatorcontrib>Holmberg, T</creatorcontrib><creatorcontrib>Larsen, M L</creatorcontrib><collection>CrossRef</collection><jtitle>European heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Graversen, C B</au><au>Johansen, M B</au><au>Johnsen, S P</au><au>Riahi, S</au><au>Holmberg, T</au><au>Larsen, M L</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>P631Socioeconomic status; how does it influence referral to cardiac rehabilitation after acute myocardial infarction?</atitle><jtitle>European heart journal</jtitle><date>2019-10-01</date><risdate>2019</risdate><volume>40</volume><issue>Supplement_1</issue><issn>0195-668X</issn><eissn>1522-9645</eissn><abstract>Abstract Background The number of patients with low socioeconomic status who are referred to cardiac rehabilitation (CR) has been documented to be relative lower than patients with high SES among all patients hospitalised with acute myocardial infarction (AMI). Purpose The aims of this study were to evaluate the referral process to CR and how it is influenced by socioeconomic variables. Methods In 2011–2014, 1229 patients were hospitalised with AMI at Department of Cardiology of our University Hospital, Denmark. All were evaluated for participation to CR. Socioeconomic status was measured by personal income, educational level, marital status, and employment and obtained from national registers. Multiple logistic regression assessed socioeconomic determinants in three phases of the referral process to CR: 1. information about CR, 2. wish to participate in CR, and 3. referral to specialiced- or municipality-based CR. All analyses were adjusted for sex, age, and comorbidities. Results A total of 1123 (91.4%) patients received information regarding CR. Of these, 854 (69.5%) patients wished to participate in the programme. Income was the most important socioeconomic variable when looking at who were informed about CR (OR 2.17, 95%-CI: 1.0- 4.64) and who wished to participate in CR (OR 1.55, 95%-CI: 1.02–2.35). Characteristics of study participants Characteristics All participants STEMI NSTEMI UAP n=1229 n=402 n=711 n=116 Male (n, %) 907 (73.8) 322 (80.1) 503 (70.7) 82 (70.7) Age Group (yrs)   &lt;65 591 (48.1) 227 (56.5) 308 (43.3) 56 (48.3)   65–74 371 (30.2) 116 (28.9) 215 (30.2) 40 (34.5)   ≥75 267 (21.7) 59 (14.7) 188 (26.4) 20 (17.2) Baseline Comorbidity   Hypertension 241 (19.6) 62 (15.4) 148 (20.8) 31 (26.7)   Diabetes 14 (1.1) &lt;5 (&lt;1) 8 (1.1) &lt;5 (&lt;1) Charlson Comorbidity Index   Low (0 points) 1088 (88.5) 358 (89.1) 630 (88.6) 100 (86.2)   Moderate/High (&gt;0) 141 (11.5) 44 (10.9) 81 (11.4) 16 (13.8) Civil status (n, %)   Married/Partnership 793 (64.5) 253 (62.9) 449 (63.2) 91 (78.4)   Divorced/Unmarried/Widow 436 (35.5) 149 (37.1) 262 (36.8) 25 (21.6) Occupational status (n, %)   Employed 479 (39.0) 195 (48.5) 240 (33.8) 44 (37.9)   Unemployed/Retired 750 (61.0) 207 (51.5) 471 (66.2) 72 (62.1) Educational status (n, %)   Low 516 (42.0) 144 (35.8) 322 (45.3) 50 (43.1)   Medium 539 (43.9) 201 (50.0) 293 (41.2) 45 (38.8)   High 174 (14.2) 57 (14.2) 96 (13.5) 21 (18.1) Gross income, tertile (n, %)   Low 405 (33.0) 113 (28.1) 251 (35.3) 41 (35.3)   Medium 406 (33.0) 124 (30.8) 247 (34.7) 35 (30.2)   High 418 (34.0) 165 (41.0) 213 (30.0) 40 (34.5) STEMI: ST-elevated myocardial infarction; NSTEMI: non-ST-elevated myocardial infarction; UAP: unstable angina pectoris. Conclusion Two out of three patients received referral to CR. However, higher income was proportional with the likelihood of receiving information about CR and willingness to participate in the programme. Acknowledgement/Funding the Danish Heart Foundation</abstract><pub>Oxford University Press</pub><doi>10.1093/eurheartj/ehz747.0239</doi></addata></record>
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title P631Socioeconomic status; how does it influence referral to cardiac rehabilitation after acute myocardial infarction?
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