National trends in admission for cardiac rehabilitation after a myocardial infarction in France from 2010 to 2014

Abstract

Follow-up care and rehabilitation services [soins de suite et réadaptation (SSR)], especially cardiac rehabilitation (CR), constitute a key stage for patients who have had an acute myocardial infarction (AMI). To study admission to SSR, especially for CR, among patients hospitalized for AMI in France in 2014, and its temporal trend between 2010 and 2014. We used the French National Hospital Database to select patients hospitalized with a main diagnosis of AMI (identified by ICD-10 codes I21 to I23) in the first semester of each year from 2010 to 2014. We then searched for rehabilitation admission in the 6 months after the index hospitalization. We calculated age-standardized rates of admission for CR and for other rehabilitation purposes. The average annual percentage change in admission rates was analysed by Poisson regression. In 2014, among the 29,424 patients hospitalized for an AMI in the first 6 months of the year, 10,873 (36.9%) were subsequently admitted to SSR units. More specifically, the age-standardized rate of patients hospitalized in CR units reached 28.4% (n=8380), and was greater among men (29.6%, n=6707) than among women (24.9%, n=1673). Between 2010 and 2014, rates of admission for CR increased by 5.0% per year in men and 6.6% per year in women. We found a great increase in ambulatory CR management, which accounted for half of the admissions for CR in 2014. Favourable trends in rates of admission for CR were reported in both sexes and at all ages, except the oldest. The increase in ambulatory management contributed to these changes. Despite these trends, rates of admission for CR after AMI remain low.