The use of geographical analysis in assessing the impact of patients’ home addresses on their participation in outpatient cardiac rehabilitation: a prospective cohort study

Environmental Health and Preventive Medicine - Tập 25 Số 1 - 2020
Atsuko Nakayama1, Masatoshi Nagayama2, Hiroyuki Morita1, Takuya Kawahara3, Issei Komuro1, Mitsuaki Isobe2
1Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
2Sakakibara Heart Institute, Tokyo, Japan
3Clinical Research Promotion Center, The University of Tokyo, Tokyo, Japan

Tóm tắt

Abstract Purpose Geographical 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). Methods All 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. Results Patients 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). Conclusions Using 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 registration UMIN000028435.

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Tài liệu tham khảo

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Environmental Health and Preventive Medicine

Tập 25 Số 1

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