Abstract
PurposeGeographical analysis is becoming a powerful tool for evaluating the quality of medical services and acquiring fundamental data for medical decision-making. Using geographical analysis, we evaluated the impact of the distance from patients’ homes to the hospital on their participation in outpatient cardiac rehabilitation (OCR).MethodsAll patients hospitalized for percutaneous coronary intervention, coronary artery bypass grafting, valvular surgery, congestive heart failure, and aortic diseases were advised to participate in an OCR program after discharge. Using the dataset of our cohort study of OCR from 2004 to 2015 (n = 9,019), we used geographical analysis to investigate the impact of the distance from patients’ homes to hospital on their participation in our OCR program.ResultsPatients whose road distance from home to hospital was 0–10 km, 10–20 km, and 20–30 km participated more in OCR than those whose road distance was ≧ 30 km (OR 4.34, 95% CI 3.80–4.96; OR 2.98, 95% CI 2.61–3.40; and OR 1.90, 95% CI 1.61–2.23, respectively). Especially in patients with heart failure, the longer the distance, the lesser the participation rate (P < .001).ConclusionsUsing geographical analysis, we successfully evaluated the factors influencing patients’ participation in OCR. This illustrates the importance of using geographical analysis in future epidemiological and clinical studies.Trial registrationUMIN000028435.
Highlights
MethodsAll patients hospitalized for percutaneous coronary intervention, coronary artery bypass grafting, valvular surgery, congestive heart failure, and aortic diseases were advised to participate in an Outpatient cardiac rehabilitation (OCR) program after discharge
Cardiovascular diseases are increasing in aging populations across the world [1]
Outpatient cardiac rehabilitation (OCR) is expected to be an effective strategy for secondary prevention of cardiovascular diseases, but the participation rate in OCR programs remains less than 50% [2]
Summary
A reverse geocoding service converted coordinates to human-readable addresses (Fig. 2a) This analysis was introduced to medical research recently [8]. Statistical methods The cut-off point for road distance from patients’ homes to the hospital for participating in the OCR program was determined by receiver operating characteristic (ROC) curve analysis. The decrease in OCR participation rate according to the road distance from home to hospital was analyzed using logistic analysis [9] with a quadratic term of distance, as a continuous variable, adjusted for age, albumin levels, and left ventricular ejection fraction to examine the strength of ‘the longer the distance, the lesser the participation in OCR’ with quadratic curve rather than a linear relationship
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
