Abstract 13727: Mapping Analysis Clarifies the Correlation Between Distribution of Patient’s Home Address and Participation in Outpatient Cardiac Rehabilitation

Abstract

Introduction: Geographical analysis is developing as a powerful tool for evaluating the quality of medical service and acquiring the fundamental data for medical decision-making. Using a geographical analysis, we can evaluate the impact of the distance from patient’s home to the hospital on the participation in outpatient cardiac rehabilitation (CR). Methods: All patients hospitalized for percutaneous coronary intervention, coronary artery bypass grafting, valvular surgery, congestive heart failure and aortic diseases were recommended to participate in outpatient-CR program after discharge. In the dataset of prospective cohort study of CR from 2004 to 2015 (n=9,019), we investigated the impact of the distance from patient’s home to hospital on the participation in outpatient-CR program using the geographical analysis. Results: The total participation rate of outpatient-CR was 47% in our study population. The participation rate of outpatient-CR was highest (62%) in patients with road distance from home to hospital < 10 km as compared with those with road distance of 10-20 km, 20-30 km and >30km to hospital (51%, 39%, and 23%, respectively, p<0.001). Patients whose road distance from home to hospital was < 30 km more participated in outpatient-CR as compared with patients whose road distance was ≧30 km (Odds ratio 4.41, 95%CI 3.86 - 5.04). Expecially in patients with heart failure, the longer distance-the less participation rate relationship was menifest (p<0.01). Conclusions: Using the geographical analysis, we could successfully evaluate the impact of road distance from patient’s home to hospital on the participation in outpatient-CR after discharge in patients with cardiovascular diseases. Especially in patients with heart failure, “the longer distance, the less participation” relationship was manifest. This geographical analysis will provide us with essential information for future epidemiological and clinical studies as well as medical decision-making, improving the healthcare service.