The current and potential capacity for cardiac rehabilitation utilization in the united states

Quinn R. Pack, Ray W. Squires, Francisco Lopez-Jimenez, Steven W. Lichtman, Juan P. Rodriguez-Escudero, Victoria N. Zysek, Randal J. Thomas

Research output: Research - peer-reviewArticle

  • 13 Citations

Abstract

Purpose: Prior studies suggest that program capacity restraints may be an important reason for outpatient cardiac rehabilitation (CR) underutilization. We sought to measure current CR capacity and growth potential. Methods: We surveyed all CR program directors listed in the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) database in November 2012. Respondents reported current enrollment levels, program capacity, expansion potential, and obstacles to growth. Results: Of the 812 program directors in the AACVPR database, 290 (36%) completed the full survey. Respondents represented somewhat larger programs than nonrespondents but were otherwise representative of all registered AACVPR programs. Current enrollment, estimated capacity, and estimated expansion capacity were reported at a median (interquartile range) of 140 (75, 232), 192 (100, 300), and 240 (141, 380) patients annually, respectively. Using these data, we estimated that, in the year 2012, national CR utilization was 28% (min, max: 20, 38) of eligible patients. Even with modest expansion of all existing programs operating at capacity, a maximum of 47% (min, max: 32, 67) of qualifying patients in the United States could be serviced by existing CR programs. Obstacles to increasing patient participation were primarily controllable system-related problems such as facility restraints and staffing needs. Conclusions: Even with substantial expansion of all existing CR programs, there is currently insufficient capacity to meet national service needs. This limit probably contributes to CR underutilization and has important policy implications. Solutions to this problem will likely include the creation of new CR programs, improved CR reimbursement strategies, and new models of CR delivery.

LanguageEnglish (US)
Pages318-326
Number of pages9
JournalJournal of Cardiopulmonary Rehabilitation and Prevention
Volume34
Issue number5
DOIs
StatePublished - 2014

Fingerprint

Cardiac Rehabilitation
Surveys and Questionnaires
Lung
Databases
Growth
Patient Participation
Outpatients

Keywords

  • capacity
  • cardiac rehabilitation
  • enrollment
  • utilization

ASJC Scopus subject areas

  • Rehabilitation
  • Cardiology and Cardiovascular Medicine
  • Pulmonary and Respiratory Medicine

Cite this

Pack, Q. R., Squires, R. W., Lopez-Jimenez, F., Lichtman, S. W., Rodriguez-Escudero, J. P., Zysek, V. N., & Thomas, R. J. (2014). The current and potential capacity for cardiac rehabilitation utilization in the united states. Journal of Cardiopulmonary Rehabilitation and Prevention, 34(5), 318-326. DOI: 10.1097/HCR.0000000000000076

The current and potential capacity for cardiac rehabilitation utilization in the united states. / Pack, Quinn R.; Squires, Ray W.; Lopez-Jimenez, Francisco; Lichtman, Steven W.; Rodriguez-Escudero, Juan P.; Zysek, Victoria N.; Thomas, Randal J.

In: Journal of Cardiopulmonary Rehabilitation and Prevention, Vol. 34, No. 5, 2014, p. 318-326.

Research output: Research - peer-reviewArticle

Pack, Quinn R. ; Squires, Ray W. ; Lopez-Jimenez, Francisco ; Lichtman, Steven W. ; Rodriguez-Escudero, Juan P. ; Zysek, Victoria N. ; Thomas, Randal J./ The current and potential capacity for cardiac rehabilitation utilization in the united states. In: Journal of Cardiopulmonary Rehabilitation and Prevention. 2014 ; Vol. 34, No. 5. pp. 318-326
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