title: Trends in referral to outpatient cardiac rehabilitation in the Hunter Region of Australia, 2002-2007.
abstract: BACKGROUND
  Cardiac rehabilitation (CR) is an underutilized evidence-based treatment. We described trends in referral to outpatient CR (OCR) and the factors associated with referral.
  
  
  METHODS
  Cross-sectional survey data provided by Hunter residents aged 20 years or older discharged from public hospitals in the region between 2002 and 2007 with an OCR eligible diagnosis were extracted from the Hunter New England Heart and Stroke Register database.
  
  
  METHODS
  Trends in referral were determined using the chi test for trend. Factors associated with referral were examined using multiple logistic regression.
  
  
  RESULTS
  Sixty-five percent (4971 of 7678) of patients provided sufficient data for inclusion in the analysis. Approximately half of the patients reported being referred to OCR. No increase over time was observed. Factors associated with referral were age less than 70 years, male sex, being married, urban residence, at least one admission to the tertiary referral hospital for cardiology, at least one admission for acute myocardial infarction, revascularization, no admissions for congestive heart failure, a self-reported history of high cholesterol, and no history of stroke or atrial fibrillation.
  
  
  CONCLUSIONS
  Access to this treatment of proven benefit remained suboptimal despite the provision of new programs and expansion of existing programs. Automatic referral, which is recommended in Australia, should be standard practice.
authors.affiliation: School of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, Australia. Natalie.Johnson@newcastle.edu.au
authors.forename: Natalie A
authors.initials: NA
authors.lastname: Johnson
authors.forename: Kerry J
authors.initials: KJ
authors.lastname: Inder
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Bowe
mesh_terms: D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000639:trends*; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005260:Female; D019983:Guideline Adherence; D006297:Health Services Accessibility / Q000639:trends*; D006331:Heart Diseases / Q000534:rehabilitation*; D006779:Hospitals, Public / Q000639:trends; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009517:New South Wales; D016017:Odds Ratio; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000639:trends*; D012017:Referral and Consultation / Q000639:trends*; D012042:Registries; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult