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Peer-reviewedCC BY-NC-NDJournal of the American Heart Association

Patient Characteristics and Outcomes Associated With Home‐Based Cardiac Rehabilitation

  • Matthew T. Mefford1
  • Matt Zhou1
  • Hui Zhou1,2
  • Teresa N. Harrison1
  • Miriam E. Silliman1
  • Erica Shin1
  • Columbus D. Batiste3,4,5
  • Debora A. Lahti5
  • Tadashi T. Funahashi3,5,6
  • Chileshe Nkonde‐Price1,3,7,2
  • Rachid A. Elkoustaf3,4
  • Kristi Reynolds1,2
7 affiliations
  1. 1Kaiser Permanente Southern California
  2. 2Kaiser Permanente Bernard J. Tyson School of Medicine
  3. 3Southern California Permanente Medical Group
  4. 4Kaiser Permanente Riverside Medical Center
  5. 5Kaiser Permanente Center for Health Innovation
  6. 6Kaiser Permanente Orange County Medical Center
  7. 7Kaiser Permanente West Los Angeles Medical Center
Open at sourceDOICite

Abstract

BACKGROUND: Referrals to and participation in cardiac rehabilitation programs remain suboptimal. We examined factors associated with home-based cardiac rehabilitation (HBCR) referral and participation and associations of referral and participation with outcomes. METHODS: In this retrospective cohort study, we included adults ≥18 years of age from Kaiser Permanente Southern California with a HBCR-qualifying event or procedure between January 2021 and September 2024. HBCR referral and, separately, participation was identified within 90 days. Outcomes included 30-, 180-, and 365-day hospitalizations and all-cause mortality. RESULTS: Among 44 468 adults, 13 164 (29.6%) received a referral within 90 days. Those receiving versus not receiving a referral were younger (mean age 65.6 versus 70.6 years) and more often male (71.4% versus 59.5%). Referral was associated with a lower likelihood of 180-day all-cause and cardiovascular disease hospitalization (prevalence ratio [PR], 0.86 [95% CI, 0.82-0.91] and PR, 0.76 [95% CI, 0.66-0.82]), and 365-day all-cause and cardiovascular disease hospitalization (PR, 0.83 [95% CI, 0.79-0.86] and PR, 0.70 [95% CI, 0.66-0.75]). Participation was associated with a lower likelihood of 30-day all-cause hospitalization (PR, 0.78 [95% CI, 0.66-0.92]), 180-day all-cause and cardiovascular disease hospitalization (PR, 0.83 [95% CI, 0.75-0.91] and PR, 0.85 [95% CI, 0.74-0.98]), and 365-day all-cause and cardiovascular disease hospitalization (PR, 0.89 [95% CI, 0.82-0.96] and PR, 0.87 [95% CI, 0.78-0.98]). CONCLUSIONS: Older adults and women had lower HBCR referral highlighting persistent gaps. Lower hospitalization risk associated with timely HBCR referral and participation underscores the importance of appropriate patient screening to improve outcomes.

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Cite

BibTeXRIS
BibTeX
@article{mefford2026patient,
  title = {{Patient Characteristics and Outcomes Associated With Home‐Based Cardiac Rehabilitation}},
  author = {Matthew T. Mefford and Matt Zhou and Hui Zhou and Teresa N. Harrison and Miriam E. Silliman and Erica Shin and Columbus D. Batiste and Debora A. Lahti and Tadashi T. Funahashi and Chileshe Nkonde‐Price and Rachid A. Elkoustaf and Kristi Reynolds},
  journal = {Journal of the American Heart Association},
  year = {2026},
  month = oct,
  doi = {10.1161/jaha.126.050248},
  url = {https://www.ahajournals.org/doi/10.1161/JAHA.126.050248},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Patient Characteristics and Outcomes Associated With Home‐Based Cardiac Rehabilitation
AU  - Matthew T. Mefford
AU  - Matt Zhou
AU  - Hui Zhou
AU  - Teresa N. Harrison
AU  - Miriam E. Silliman
AU  - Erica Shin
AU  - Columbus D. Batiste
AU  - Debora A. Lahti
AU  - Tadashi T. Funahashi
AU  - Chileshe Nkonde‐Price
AU  - Rachid A. Elkoustaf
AU  - Kristi Reynolds
PY  - 2026
DA  - 2026/10/20
JO  - Journal of the American Heart Association
DO  - 10.1161/jaha.126.050248
UR  - https://www.ahajournals.org/doi/10.1161/JAHA.126.050248
AB  - BACKGROUND: Referrals to and participation in cardiac rehabilitation programs remain suboptimal. We examined factors associated with home-based cardiac rehabilitation (HBCR) referral and participation and associations of referral and participation with outcomes. METHODS: In this retrospective cohort study, we included adults ≥18 years of age from Kaiser Permanente Southern California with a HBCR-qualifying event or procedure between January 2021 and September 2024. HBCR referral and, separately, participation was identified within 90 days. Outcomes included 30-, 180-, and 365-day hospitalizations and all-cause mortality. RESULTS: Among 44 468 adults, 13 164 (29.6%) received a referral within 90 days. Those receiving versus not receiving a referral were younger (mean age 65.6 versus 70.6 years) and more often male (71.4% versus 59.5%). Referral was associated with a lower likelihood of 180-day all-cause and cardiovascular disease hospitalization (prevalence ratio [PR], 0.86 [95% CI, 0.82-0.91] and PR, 0.76 [95% CI, 0.66-0.82]), and 365-day all-cause and cardiovascular disease hospitalization (PR, 0.83 [95% CI, 0.79-0.86] and PR, 0.70 [95% CI, 0.66-0.75]). Participation was associated with a lower likelihood of 30-day all-cause hospitalization (PR, 0.78 [95% CI, 0.66-0.92]), 180-day all-cause and cardiovascular disease hospitalization (PR, 0.83 [95% CI, 0.75-0.91] and PR, 0.85 [95% CI, 0.74-0.98]), and 365-day all-cause and cardiovascular disease hospitalization (PR, 0.89 [95% CI, 0.82-0.96] and PR, 0.87 [95% CI, 0.78-0.98]). CONCLUSIONS: Older adults and women had lower HBCR referral highlighting persistent gaps. Lower hospitalization risk associated with timely HBCR referral and participation underscores the importance of appropriate patient screening to improve outcomes.
SN  - 2047-9980
ER  -