Many Hospitals Fall Short in Referrals to Cardiac Rehab

Percutaneous coronary intervention, or PCI, is a non-surgical procedure that helps open blocked arteries in patients with heart disease. While cardiac rehabilitation helps patients recover after heart procedures, not all patients take advantage of these programs, causing concern among medical experts.

In a recent study published in the Journal of the American College of Cardiology, researchers analyzed how often patients are referred to cardiac rehab after PCI. Using data from the National Cardiovascular Data Registry, researchers identified more than 1.4 million patients who underwent PCI between 2009 and 2012. Overall, only three in five patients were referred to cardiac rehab by their doctor, which is the first step needed to become eligible for such services. However, referral rates varied significantly by hospital.

Among more than 1,300 hospitals that participate in the national registry, certain hospitals had very low referral rates, while others were considered high performers. More than one-quarter of all hospitals referred less than 20% of patients to cardiac rehab after PCI. Another quarter of hospitals brought up the average by referring more than 80% of all PCI patients to cardiac rehab.

Researchers also point out that while referral rates were inconsistent, prescription rates of appropriate medication was very high. For example, aspirin was prescribed to 98% of all PCI patients and cholesterol-lowering statins were prescribed to 90% of patients.

On one hand, findings are discouraging. Between 2009 and 2012, there was only a small increase in referral rates among U.S. hospitals, despite the known benefits of cardiac rehab. While prescription of preventive medicines was high across the board, referral to follow-up care is clearly overlooked in many cases.

The good news, however, is that researchers have helped identify a key source of this problem. National utilization of cardiac rehab is low, at least in part because certain hospitals rarely refer patients to cardiac rehab following heart procedures.

Since a referral is needed to attend cardiac rehab, many eligible patients are missing an important opportunity to improve their health. Not only does cardiac rehab help patients recover following a heart procedure, it helps patients adopt lifelong health behaviors that can improve outcomes and quality of life. Therefore, hospitals with low referrals to cardiac rehab can learn from the high performers to create policies and procedures that increase referrals and utilization of follow-up care.