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: | Repositório Institucional da UNESP |
Texto Completo: | http://dx.doi.org/10.1590/1516-3180.2020.0782.R1.31052021 http://hdl.handle.net/11449/234055 |
Resumo: | 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 counter-parts. 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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Publicly versus privately funded cardiac rehabilitation: access and adherence barriers. A cross-sectional studyCardiac rehabilitationCardiovascular diseasesDelivery of health carePrivate sectorPublic sectorSurveys and questionnairesBACKGROUND: 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 counter-parts. 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.Universidade Estadual PaulistaFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Department of Physiotherapy School of Technology and Sciences Universidade Estadual Paulista (UNESP), SPEscola Superior de Saúde Egas Moniz (ESSEM) Egas Moniz-Cooperativa de Ensino Superior (CRL)Faculty of Health York UniversityKITE & Peter Munk Cardiac Centre University Health Network University of TorontoDepartment of Physiotherapy School of Technology and Sciences Universidade Estadual Paulista (UNESP), SPFAPESP: 2018/18276-6CNPq: 46124Universidade Estadual Paulista (UNESP)Egas Moniz-Cooperativa de Ensino Superior (CRL)York UniversityUniversity of TorontoBorges, Giovanna Lombardi Bonini [UNESP]da Cruz, Mayara Moura Alves [UNESP]Ricci-Vitor, Ana Laurada Silva, Paula Fernanda [UNESP]Grace, Sherry LynnVanderlei, Luiz Carlos Marques [UNESP]2022-05-01T12:56:30Z2022-05-01T12:56:30Z2022-01-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article108-114http://dx.doi.org/10.1590/1516-3180.2020.0782.R1.31052021Sao Paulo Medical Journal, v. 140, n. 1, p. 108-114, 2022.1516-3180http://hdl.handle.net/11449/23405510.1590/1516-3180.2020.0782.R1.310520212-s2.0-85123567809Scopusreponame:Repositório Institucional da UNESPinstname:Universidade Estadual Paulista (UNESP)instacron:UNESPengSao Paulo Medical Journalinfo:eu-repo/semantics/openAccess2024-06-18T18:43:49Zoai:repositorio.unesp.br:11449/234055Repositório InstitucionalPUBhttp://repositorio.unesp.br/oai/requestopendoar:29462024-08-05T16:42:42.853649Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)false |
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 [UNESP] Cardiac rehabilitation Cardiovascular diseases Delivery of health care Private sector Public sector Surveys and questionnaires |
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 [UNESP] |
author_facet |
Borges, Giovanna Lombardi Bonini [UNESP] da Cruz, Mayara Moura Alves [UNESP] Ricci-Vitor, Ana Laura da Silva, Paula Fernanda [UNESP] Grace, Sherry Lynn Vanderlei, Luiz Carlos Marques [UNESP] |
author_role |
author |
author2 |
da Cruz, Mayara Moura Alves [UNESP] Ricci-Vitor, Ana Laura da Silva, Paula Fernanda [UNESP] Grace, Sherry Lynn Vanderlei, Luiz Carlos Marques [UNESP] |
author2_role |
author author author author author |
dc.contributor.none.fl_str_mv |
Universidade Estadual Paulista (UNESP) Egas Moniz-Cooperativa de Ensino Superior (CRL) York University University of Toronto |
dc.contributor.author.fl_str_mv |
Borges, Giovanna Lombardi Bonini [UNESP] da Cruz, Mayara Moura Alves [UNESP] Ricci-Vitor, Ana Laura da Silva, Paula Fernanda [UNESP] Grace, Sherry Lynn Vanderlei, Luiz Carlos Marques [UNESP] |
dc.subject.por.fl_str_mv |
Cardiac rehabilitation Cardiovascular diseases Delivery of health care Private sector Public sector Surveys and questionnaires |
topic |
Cardiac rehabilitation Cardiovascular diseases Delivery of health care Private sector Public sector Surveys and questionnaires |
description |
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 counter-parts. 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 |
2022-05-01T12:56:30Z 2022-05-01T12:56:30Z 2022-01-01 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.1590/1516-3180.2020.0782.R1.31052021 Sao Paulo Medical Journal, v. 140, n. 1, p. 108-114, 2022. 1516-3180 http://hdl.handle.net/11449/234055 10.1590/1516-3180.2020.0782.R1.31052021 2-s2.0-85123567809 |
url |
http://dx.doi.org/10.1590/1516-3180.2020.0782.R1.31052021 http://hdl.handle.net/11449/234055 |
identifier_str_mv |
Sao Paulo Medical Journal, v. 140, n. 1, p. 108-114, 2022. 1516-3180 10.1590/1516-3180.2020.0782.R1.31052021 2-s2.0-85123567809 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Sao Paulo Medical Journal |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
108-114 |
dc.source.none.fl_str_mv |
Scopus reponame:Repositório Institucional da UNESP instname:Universidade Estadual Paulista (UNESP) instacron:UNESP |
instname_str |
Universidade Estadual Paulista (UNESP) |
instacron_str |
UNESP |
institution |
UNESP |
reponame_str |
Repositório Institucional da UNESP |
collection |
Repositório Institucional da UNESP |
repository.name.fl_str_mv |
Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP) |
repository.mail.fl_str_mv |
|
_version_ |
1808128689929453568 |