Relationship Between Participation of In-Hospital Cardiac Rehabilitation and Regional Characteristics in Japan - Insight From the Japanese Registry of All Cardiac and Vascular Diseases and the Diagnosis Procedure Combination.

Circulation reports Pub Date : 2024-09-05 eCollection Date: 2024-10-10 DOI:10.1253/circrep.CR-24-0048
Akinori Sawamura, Koshiro Kanaoka, Tetsufumi Motokawa, Satoshi Katano, Yuji Kono, Yusuke Ohya, Shin-Ichiro Miura, Nagaharu Fukuma, Shigeru Makita, Yoshihiro Miyamoto, Hideo Izawa
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Abstract

Background: The influence of various regional backgrounds on participation in cardiac rehabilitation (CR) remains underexplored. We investigated the regional characteristics that potentially promote CR participation.

Methods and results: This was a nationwide cross-sectional cohort study using the Japanese Registry of All Cardiac and Vascular Diseases and the Diagnosis Procedure Combination. This study included a cohort of 2.7 million inpatients hospitalized between April 2012 and March 2021. The CR participation rate for each hospital was calculated as the percentage of eligible patients who underwent CR during their admission. Among all hospitals, those that do not perform CR were defined as No-CR hospitals. The remaining hospitals were categorized into High- and Low-CR hospitals based on the median level of the CR participation rate (41.5%). High-CR hospitals had significantly smaller medical service areas (P<0.0001), a higher number of physicians per population (P<0.0001), higher air temperature (P=0.02), and fewer primary industry workers (P=0.005) than the other 2 groups. Logistic regression analyses revealed that a lower consumer price index was a significant regional factor that characterized High-CR hospitals, and a lower population aged ≥65 years was a factor approaching significance that characterized the region where High-CR hospitals are located.

Conclusions: High-CR hospitals were found in regions with a lower consumer price index and a trend towards a lower population aged ≥65 years.

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日本参与院内心脏康复与地区特征之间的关系--来自日本所有心脏和血管疾病登记及诊断程序组合的启示。
背景:不同地区背景对参与心脏康复(CR)的影响仍未得到充分探讨。我们调查了可能促进参与心脏康复的地区特征:这是一项全国范围的横断面队列研究,使用的是日本所有心脏和血管疾病登记及诊断程序组合。研究对象包括 2012 年 4 月至 2021 年 3 月期间住院的 270 万名住院患者。每家医院的 CR 参与率按符合条件的患者在入院期间接受 CR 的百分比计算。在所有医院中,不进行 CR 的医院被定义为无 CR 医院。其余医院根据 CR 参与率的中位数(41.5%)分为高 CR 医院和低 CR 医院。高CR医院的医疗服务区域(PConclusions:高CR医院位于消费物价指数较低的地区,且≥65岁的人口数量呈下降趋势。
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