Cardiac rehabilitation services in England and Wales: a national survey.
We sent a short postal questionnaire to 244 centres in England and Wales that admitted patients with cardiac conditions. In total, 199 (81%) of the centres claimed to provide a cardiac rehabilitation service. Of these, 25 were randomly selected as a representative sample and visited in order to obtain detailed information concerning the provision of services. Most (18 (72%)) of the centres had commenced their rehabilitation programme within the previous 5 years, usually at the instigation of interested staff. Patient entry to cardiac rehabilitation programmes was restricted; women (who represented only 15% of attenders), elderly people (excluded in 10 (40%) centres), and those with more complex problems, such as angina or heart failure, were under-represented. The central components of all programmes were education and exercise training but there was a wide range in the quantity and quality of service provision. Most (22 (88%)) programmes were hospital out-patient based, one (4%) was hospital in-patient based, one (4%) was community-based and one (4%) was home-based. The staffing and funding of programmes was variable, with 7 (28%) having no identified funding. There are wide variations in the resources currently available for the rehabilitation of patients with coronary heart disease. There is a need for clearer direction of these services, in particular to determine minimum service provision. Guidelines are necessary to give a framework for this relatively new and rapidly expanding service.
Thompson
D R
DR
School of Health, University of Hull, UK.
Bowman
G S
GS
Kitson
A L
AL
de Bono
D P
DP
Hopkins
A
A
D000368:Aged; D003327:Coronary Disease / Q000534:rehabilitation*; D003695:Delivery of Health Care / Q000191:economics / Q000458:organization & administration*; D004739:England; D005080:Exercise Test / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008503:Medical Staff / Q000458:organization & administration; D010353:Patient Education as Topic; D016730:Program Development / Q000191:economics / Q000379:methods*; D012047:Rehabilitation Centers / Q000191:economics / Q000458:organization & administration*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D014852:Wales; D014938:Work Capacity Evaluation; D000078329:Workforce