Trends in the Use of Cardiac Rehabilitation Following a Myocardial Infarction, France, 2010–2014

Introduction: The objective was to describe national and regional rates of utilization of follow-up care and rehabilitation (FCR), particularly cardiac rehabilitation (CR), following hospitalization for myocardial infarction (MI) in France in 2014, and to analyze trends in the utilization of CR following MI between 2010 and 2014. Methods: Patients hospitalized with a primary diagnosis of MI (ICD-10 codes I21 to I23) in the first half of each year between 2010 and 2014 were selected from the PMSI-MCO databases (Program for the Medicalization of Information Systems in Medicine, Surgery, and Obstetrics). For these patients, a stay in a post-acute care unit was sought up to six months after discharge from the index hospitalization for AMI. National and regional age-standardized rates of use of emergency care and hospitalizations in post-acute care units for “other reasons” following AMI were calculated, and their trends were analyzed using Poisson regression. Results: Among the 29,424 patients hospitalized for AMI in the first half of 2014, 36.9% (n=10,873) were admitted to an acute care unit and 28.5% to a rehabilitation unit (n=8,380). The age-standardized rate of admission to general care was significantly higher among men (29.6%, n=6,707) than among women (24.9%, n=1,673). Between 2010 and 2014, an average annual increase in the rate of use of outpatient care was observed among men (+5.0%) and women (+6.6%). The proportion of inpatient hospitalizations for outpatient care decreased in favor of outpatient care (p<0.0001). Finally, significant regional disparities were recorded, both in terms of rates and temporal trends between 2010 and 2014. Conclusion: increases in the rates of admission to acute care and long-term care following an AMI were observed. These are partly attributable to the increase in outpatient care. However, admissions to the CCU remained low, especially among older adults. The analysis of regional disparities highlights significant geographical inequalities that need to be addressed to ensure equitable care across the entire country.

Author(s): Gabet A, de Peretti C, Nicolau J, Iliou MC, Olie V

Publishing year: 2016

Pages: 764-74

Weekly Epidemiological Bulletin, 2016, n° 43, p. 764-74

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