Closing The Treatment Gap With Cardiac Rehabilitation In A Heartcare Partnership

Abstract

South Carolinians rank in the top tier for heart disease deaths on which they spend $3.8 billion annually. South Carolina's Upstate HeartCare Partnership includes hundreds of clinicians from hospitals, physician practices, and rehabilitation programs working collaboratively to bridge the treatment gap between clinical practice and AHA/ACC recommendations (e.g., “Get With the Guidelines”) for improving patient care and target outcomes. From a database of ∼60,000 patient charts, 3230 were randomly selected (over a three year period) to assess outcomes for coronary artery disease (CAD) management. Patient charts were selected to represent progress toward target outcomes and the standard of care at 14 physician practices (5 family practice; 5 internal medicine; 4 cardiology) and completion of comprehensive cardiac rehabilitation (4 programs). The Table below depicts the percent of patients achieving the 8 target outcomes. Physician practices were grouped into a single cohort to retain confidentiality with data expressed as the percent range across all practices. Patients treated at physician practices achieved 3 of the 8 target outcomes. Patients who were referred to and completed a cardiac rehabilitation program achieved 6 target outcomes.TableThe data indicate that patients referred to cardiac rehabilitation programs are more likely to achieve the AHA/ACC guidelines for patient care and CAD target outcomes. The model implemented in South Carolina's Upstate HeartCare Partnership demonstrates that multidisciplinary management of CAD target outcomes can narrow the treatment gap and that the more aggressively patients are managed the closer they will come to achieving treatment goals.