Publicly versus privately funded cardiac rehabilitation: access and adherence barriers. A cross-sectional study
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | São Paulo medical journal (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802022000100108 |
Resumo: | 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 AND SETTING: 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. |
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São Paulo medical journal (Online) |
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Publicly versus privately funded cardiac rehabilitation: access and adherence barriers. A cross-sectional studyCardiac rehabilitationCardiovascular diseasesDelivery of health carePrivate sectorSurveys and questionnairesPublic sectorBarriers to cardiac rehabilitationPublic healthcare systemPatients’ characteristicsABSTRACT 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 AND SETTING: 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.Associação Paulista de Medicina - APM2022-02-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802022000100108Sao Paulo Medical Journal v.140 n.1 2022reponame:São Paulo medical journal (Online)instname:Associação Paulista de Medicinainstacron:APM10.1590/1516-3180.2020.0782.r1.31052021info:eu-repo/semantics/openAccessBorges,Giovanna Lombardi BoniniCruz,Mayara Moura Alves daRicci-Vitor,Ana LauraSilva,Paula Fernanda daGrace,Sherry LynnVanderlei,Luiz Carlos Marqueseng2022-01-12T00:00:00Zoai:scielo:S1516-31802022000100108Revistahttp://www.scielo.br/spmjhttps://old.scielo.br/oai/scielo-oai.phprevistas@apm.org.br1806-94601516-3180opendoar:2022-01-12T00:00São Paulo medical journal (Online) - Associação Paulista de Medicinafalse |
dc.title.none.fl_str_mv |
Publicly versus privately funded cardiac rehabilitation: access and adherence barriers. A cross-sectional study |
title |
Publicly versus privately funded cardiac rehabilitation: access and adherence barriers. A cross-sectional study |
spellingShingle |
Publicly versus privately funded cardiac rehabilitation: access and adherence barriers. A cross-sectional study Borges,Giovanna Lombardi Bonini Cardiac rehabilitation Cardiovascular diseases Delivery of health care Private sector Surveys and questionnaires Public sector Barriers to cardiac rehabilitation Public healthcare system Patients’ characteristics |
title_short |
Publicly versus privately funded cardiac rehabilitation: access and adherence barriers. A cross-sectional study |
title_full |
Publicly versus privately funded cardiac rehabilitation: access and adherence barriers. A cross-sectional study |
title_fullStr |
Publicly versus privately funded cardiac rehabilitation: access and adherence barriers. A cross-sectional study |
title_full_unstemmed |
Publicly versus privately funded cardiac rehabilitation: access and adherence barriers. A cross-sectional study |
title_sort |
Publicly versus privately funded cardiac rehabilitation: access and adherence barriers. A cross-sectional study |
author |
Borges,Giovanna Lombardi Bonini |
author_facet |
Borges,Giovanna Lombardi Bonini Cruz,Mayara Moura Alves da Ricci-Vitor,Ana Laura Silva,Paula Fernanda da Grace,Sherry Lynn Vanderlei,Luiz Carlos Marques |
author_role |
author |
author2 |
Cruz,Mayara Moura Alves da Ricci-Vitor,Ana Laura Silva,Paula Fernanda da Grace,Sherry Lynn Vanderlei,Luiz Carlos Marques |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
Borges,Giovanna Lombardi Bonini Cruz,Mayara Moura Alves da Ricci-Vitor,Ana Laura Silva,Paula Fernanda da Grace,Sherry Lynn Vanderlei,Luiz Carlos Marques |
dc.subject.por.fl_str_mv |
Cardiac rehabilitation Cardiovascular diseases Delivery of health care Private sector Surveys and questionnaires Public sector Barriers to cardiac rehabilitation Public healthcare system Patients’ characteristics |
topic |
Cardiac rehabilitation Cardiovascular diseases Delivery of health care Private sector Surveys and questionnaires Public sector Barriers to cardiac rehabilitation Public healthcare system Patients’ characteristics |
description |
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 AND SETTING: 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. |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-02-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802022000100108 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802022000100108 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/1516-3180.2020.0782.r1.31052021 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Associação Paulista de Medicina - APM |
publisher.none.fl_str_mv |
Associação Paulista de Medicina - APM |
dc.source.none.fl_str_mv |
Sao Paulo Medical Journal v.140 n.1 2022 reponame:São Paulo medical journal (Online) instname:Associação Paulista de Medicina instacron:APM |
instname_str |
Associação Paulista de Medicina |
instacron_str |
APM |
institution |
APM |
reponame_str |
São Paulo medical journal (Online) |
collection |
São Paulo medical journal (Online) |
repository.name.fl_str_mv |
São Paulo medical journal (Online) - Associação Paulista de Medicina |
repository.mail.fl_str_mv |
revistas@apm.org.br |
_version_ |
1754209268141129728 |