Gender differences in referral to cardiac rehabilitation programs after revascularization.
BACKGROUND
This study examines the influence of gender on the healthcare provider's secondary prevention instruction and cardiac rehabilitation (CR) referral after coronary revascularization procedures such as balloon angioplasty/coronary stenting and coronary bypass surgery (CABG). Cardiac rehabilitation decreases mortality and morbidity, yet only a small percentage of women and men are referred to these programs. The patient population of our university-affiliated CR program consisted of 88% men and 12% women.


METHODS
In a matched case observational study, 80 patients (40 men, 40 women) who had undergone coronary revascularization procedures between 1997 and 1998 completed a questionnaire on secondary prevention instruction and written referral to CR programs. Patients were matched for age and coronary revascularization procedure.


RESULTS
Women were less likely to be instructed on secondary prevention strategies and CR or referred to CR as compared to men despite being matched for age and undergoing the same procedure. The data demonstrate a gender difference in hospital teaching and referral information for CR after revascularization (P < 0.001). Being a woman was associated with a decreased likelihood of receiving a physician referral to CR after revascularization (P < 0.001).


CONCLUSIONS
The instruction of patients concerning secondary prevention and CR postrevascularization procedures is poor. Within that group, women were far less likely to have CR discussed or referrals made by healthcare professionals. This study demonstrates the need for education initiatives of all healthcare providers on the comprehensive nature and benefits of CR in the secondary prevention of cardiovascular disease, with a particular emphasis on women.
Division of Cardiovascular Medicine, Department of Psychiatry, Yale University School of Medicine, 333 Cedar Street, 3FMP, P.O. Box 208017, New Haven, CT 06520-8017, USA.
T
T
Caulin-Glaser
M
M
Blum
R
R
Schmeizl
H G
HG
Prigerson
B
B
Zaret
C M
CM
Mazure
D000328:Adult; D000368:Aged; D000072038:Cardiac Rehabilitation; D002318:Cardiovascular Diseases / Q000503:physiopathology*; D003625:Data Collection; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000534:rehabilitation* / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012047:Rehabilitation Centers / Q000706:statistics & numerical data*; D012727:Sex Characteristics