Publicly versus privately funded cardiac rehabilitation: access and adherence barriers. A cross-sectional study
São Paulo med. j
;
140(1): 108-114, Jan.-Feb. 2022. tab
Artículo
en Inglés
| LILACS
| ID: biblio-1357455
ABSTRACT
ABSTRACT BACKGROUND:
Cardiac rehabilitation (CR) barriers are well-understood in high-resource settings. However, they are under-studied in low-resource settings, where access is even poorer and the context is significantly different, including two-tiered healthcare systems and greater socioeconomic challenges.OBJECTIVE:
To investigate differences in characteristics of patients attending publicly versus privately funded CR and their barriers to adherence. DESIGN ANDSETTING:
Observational, cross-sectional study in public and private CR programs offered in Brazil.METHODS:
Patients who had been attending CR for ≥ 3 months were recruited from one publicly and one privately funded CR program. They completed assessments regarding sociodemographic and clinical characteristics and the CR Barriers Scale.RESULTS:
From the public program, 74 patients were recruited, and from the private, 100. Participants in the public program had significantly lower educational attainment (P < 0.001) and lower socioeconomic status (P < 0.001). Participants in the private program had more cognitive impairment (P = 0.015), and in the public program more anxiety (P = 0.001) and depressive symptoms (P = 0.008) than their counterparts. Total barriers among public CR participants were significantly higher than those among private CR participants (1.34 ± 0.26 versus 1.23 ± 0.15/5]; P = 0.003), as were scores on 3 out of 5 subscales, namely comorbidities/functional status (P = 0.027), perceived need (P < 0.001) and access (P = 0.012).CONCLUSION:
Publicly funded programs need to be tailored to meet their patients' requirements, through consideration of educational and psychosocial matters, and be amenable to mitigation of patient barriers relating to presence of comorbidities and poorer health status.
Texto completo:
Disponible
Índice:
LILACS (Américas)
Asunto principal:
Rehabilitación Cardiaca
Tipo de estudio:
Estudio observacional
/
Estudio de prevalencia
/
Factores de riesgo
Límite:
Humanos
País/Región como asunto:
America del Sur
/
Brasil
Idioma:
Inglés
Revista:
São Paulo med. j
Asunto de la revista:
Cirurgia Geral
/
Cincia
/
Ginecologia
/
Medicina
/
Medicina Interna
/
Obstetr¡cia
/
Pediatria
/
Sa£de Mental
/
Sa£de P£blica
Año:
2022
Tipo del documento:
Artículo
País de afiliación:
Brasil
/
Canadá
/
Portugal
Institución/País de afiliación:
Escola Superior de Saúde Egas Moniz/PT
/
Universidade Estadual Paulista/BR
/
York University/CA
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