Geographic issues in cardiac rehabilitation utilization: a narrative review.
OBJECTIVE
The purpose of this study was to review the current evidence regarding the relationship between geographic indicators and cardiac rehabilitation (CR) utilization among coronary heart disease (CHD) patients.


RESULTS
Seventeen articles were identified for inclusion, where nine studies assessed rurality, 10 studies assessed travel time/distance, and two of these studies assessed both. Nine of the 17 studies (52.9%) showed a significant negative relationship between geographic barrier and CR use. Four of the 17 studies (23.5%) showed a null relationship, while four studies (23.5%) showed mixed findings. Inconsistent findings identified appeared to be related to restricted geographic range, regional density, and socioeconomic status.


CONCLUSIONS
Overall, 52.9% of the identified studies reported a significant negative relationship between geographic indicators and CR utilization. This relationship appeared to be particularly consistent in North American and Australian settings, but somewhat less so in the United Kingdom where there is greater population density and availability of public transport.
Leung
Yvonne W
YW
School of Kinesiology and Health Science, York University, Toronto, Canada.
Brual
Janette
J
Macpherson
Alison
A
Grace
Sherry L
SL
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003327:Coronary Disease / Q000534:rehabilitation*; D005260:Female; D005843:Geography; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D012046:Rehabilitation / Q000706:statistics & numerical data; D012047:Rehabilitation Centers / Q000706:statistics & numerical data*