RT Journal Article
SR Electronic
T1 Does socially differentiated cardiac rehabilitation affect the use of healthcare services after myocardial infarction? A 10-year follow-up study
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e030807
DO 10.1136/bmjopen-2019-030807
VO 9
IS 10
A1 Kathrine Hald
A1 Lucette Kirsten Meillier
A1 Kirsten M. Nielsen
A1 Finn Breinholt Larsen
A1 Martin Berg Johansen
A1 Mogens Lytken Larsen
A1 Claus Vinther Nielsen
A1 Bo Christensen
YR 2019
UL http://bmjopen.bmj.com/content/9/10/e030807.abstract
AB Objective To examine the long-term effect of a socially differentiated cardiac rehabilitation (CR) intervention tailored to reduce social inequalities in health regarding use of healthcare services in general practice and hospital among socially vulnerable patients admitted with first-episode myocardial infarction (MI).Design A prospective cohort study with 10 years’ follow-up.Setting Department of cardiology at a university hospital in Denmark between 2000 and 2004.Participants Patients <70 years admitted with first-episode MI categorised as socially vulnerable (n=208) or non-socially vulnerable (n=171) based on educational level and social network.Intervention A socially differentiated CR intervention. The intervention consisted of standard CR and expanded CR with focus on cross-sectional collaboration.Main outcome measures Participation in annual chronic care consultations in general practice, contacts to general practice, all-cause hospitalisations and cardiovascular readmissions.Results At 2-year and 5-year follow-up, socially vulnerable patients receiving expanded CR participated significantly more in annual chronic care consultations (p=0.02 and p<0.01) but at 10-year follow-up, there were no significant differences in annual chronic care consultations (p=0.13). At 10-year follow-up, socially vulnerable patients receiving standard CR had significantly more contacts to general practice (p=0.03). At 10-year follow-up, there were no significant differences in the proportion of socially vulnerable patients receiving expanded CR in the mean number of all-cause hospitalisations and cardiovascular readmissions (p>0.05).Conclusions The present study found no persistent association between the socially differentiated CR intervention and use of healthcare services in general practice and hospital in patients admitted with first-episode MI during a 10-year follow-up.