Abstract P253: Ethnic Disparities in Referral to and Enrollment Among Patients in Cardiac Rehabilitation

Abstract

Background: Despite the convincing evidence and practice guidelines for cardiac rehabilitation (CR), it has been consistently documented that 20% of eligible patients actually enroll in CR. Studies have shown multiple reasons for this non-utilization, but few have documented enrollment ethnicity differences. Objective: The purpose of this study is to document ethnic disparities deter enrollment of patients to CR. We speculate that maybe ethnic, cultural, and language are barriers to enrollment into CR. Methods: The study sample comprised of five hundred ninety-six adult patients (age 65.47 ± 12.02) discharged from New York Hospital Queens, community-based hospital serving a multi-diverse population in Queens, New York following acute myocardial infarction (MI), percutaneous coronary intervention (PCI), and/or coronary artery bypass surgery (CABS) in the year 2009. All patients were referred through liaison referral. Data was obtained from the Register database (gender, age, clinical information). Results: Of the 596 patients referred to our CR program, one hundred five patients (17.5%) enrolled in CR. Of the total number of patients referred (n= 596), Asian (n=177, 29.7%), Caucasians (n=246, 41.3%); African Americans (n=49, 8%), Hispanics (n=107 18%), Others (American Indian, Middle-Eastern, etc.) (n=17, 3%), significant disparities among the ethnic groups were noted respectively, Asian (n=14, 7.9%), Caucasian (n= 51, 20.7%), African-American (n=17, 34.7%), Hispanic (22, 20.6%), and Others (n=1, 5.9%). The most remarkable and profound difference was in the Asians enrolled (7.9%, 14/77). This was in sharp contrast as compared to the other ethnic groups enrolled into CR. Conclusions: The results show substantially lower levels of CR participation among Asians. We surmise that language barriers, ethnic and cultural perceptions, and physician referral patterns in Asians, may be among the factors that create this barrier to entry. Future CR efforts should be directed to breaking down these ethnic barriers thereby allowing higher participation rates by patients that belong to these ethnic groups.