title: Multidisciplinary outpatient rehabilitation following cardiac revascularization or valve surgery: patient-related factors for uptake.
abstract: BACKGROUND
  There are concerns in Europe regarding the service provision and accessibility of multidisciplinary cardiac rehabilitation (MDCR) in general, and particularly in ambulatory settings. This paper analyses the utilization of outpatient MDCR and its determinants after cardiac revascularization or valve surgery in Belgium.
  
  
  METHODS
  Claims rehabilitation data for all patients discharged in 2007 after a percutaneous cardiac intervention or cardiac surgery were available from the Belgian Common Sickness Funds Agency. Logistic regressions were performed to identify patients demographic and socioeconomic characteristics associated with the uptake of outpatient MDCR during the year following the hospital discharge.
  
  
  RESULTS
  A total of 29,021 patients were included. During the hospitalization for the cardiac procedure, 44% were offered inpatient MDCR. After discharge, only 15.6% followed at least one session of outpatient MDCR. The chance of attending outpatient MDCR was lower for female, disabled, and older patients, as well as unemployed patients. The absence of an authorized MDCR centre in the neighbourhood of the patient's residence decreased the chance of attending outpatient MDCR, while living in a neighbourhood with a high education and income level increased this probability.
  
  
  CONCLUSIONS
  These results confirm the low rates of MDCR attendance found in a previous study performed by the European Association of Cardiovascular Prevention and Rehabilitation. The study shows specific patient groups that should be targeted in priority, i.e. women, elderly, unemployed patients, disabled persons, and patients with a low socioeconomic status.
authors.affiliation: Deloitte Consulting, Diegem, Belgium. dstrens@realidad.be
authors.forename: Daniëlle
authors.initials: D
authors.lastname: Strens
authors.forename: An
authors.initials: A
authors.lastname: Colle
authors.forename: France
authors.initials: F
authors.lastname: Vrijens
authors.forename: Dominique
authors.initials: D
authors.lastname: Paulus
authors.forename: Maria
authors.initials: M
authors.lastname: Eyssen
authors.forename: Hans
authors.initials: H
authors.lastname: Van Brabandt
authors.forename: Ilse
authors.initials: I
authors.lastname: Van Vlaenderen
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D001530:Belgium; D006348:Cardiac Surgical Procedures / Q000534:rehabilitation*; D019033:Delivery of Health Care, Integrated / Q000706:statistics & numerical data*; D006233:Persons with Disabilities; D005260:Female; D006302:Health Services Research; D006351:Heart Valves / Q000601:surgery*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000534:rehabilitation*; D010342:Patient Acceptance of Health Care; D010348:Patient Care Team / Q000706:statistics & numerical data*; D010351:Patient Discharge; D012111:Residence Characteristics; D012307:Risk Factors; D012737:Sex Factors; D014478:Unemployment