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UNC-CH study finds N.C. outpatient heart rehabilitation programs mostly under-used

rvices offered, locations, staffing, training, patient populations and other program characteristics.

Such rehabilitation efforts include medical evaluation, reduction of risk factors such as stress and smoking, nutritional counseling, aerobic exercise, weight training and education about work, drugs, weight loss and other healthy practices, she said.

Researchers did not investigate inpatient cardiac rehabilitation efforts since those are short-term, lasting only as long as patients are hospitalized. People who could benefit from longer-term rehabilitation include those who have suffered heart attacks, have undergone bypass surgery or experienced angina, chest pains resulting from an inadequate oxygen supply to the heart.

Other findings were that: . 50 of the state's 100 counties had cardiac rehabilitation programs, mostly organized around hospitals. . lack of money was among the most common reasons patients said they did not participate. . the coastal plain had the fewest programs. . patients traveled an average maximum of 30 miles to reach them. . only four programs routinely operated at full capacity.

"We need to consider alternative efforts to help people who live too far away from cardiac rehabilitation centers," Evenson said. "We also need to understand better why people who do live close by often do not take advantage of these services."

Among the possibilities are increased use of nurse case managers who offer counseling and often can monitor heart rhythms over the telephone, she said. Patients need to check with their health maintenance organizations or insurance carriers and doctors to find out whether outpatient cardiac rehabilitation is covered by insurance.


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Contact: David Williamson
david_williamson@unc.edu
919-962-8596
University of North Carolina at Chapel Hill
28-Mar-2000


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