{"doi":"10.1016/j.jacadv.2024.101275","title":"Is 70% Achievable? Hospital-Level Variation in Rates of Cardiac Rehabilitation Use Among Medicare Beneficiaries","abstract":"Background: Despite national goals to enroll 70% of cardiac rehabilitation (CR)-eligible patients, enrollment remains low. Objectives: The purpose of this study was to evaluate how the treating hospital influences CR enrollment nationally. Methods: We included Fee-for-Service Medicare beneficiaries aged ≥66 years who were hospitalized for acute myocardial infarction, coronary artery bypass grafting, percutaneous coronary intervention, or heart valve repair/replacement. We examined: 1) a risk-standardized model to assess comparative hospital rates; 2) a linear regression model to identify hospital factors associated with rates of risk-standardized CR; and 3) a hierarchical generalized linear model to calculate the hospital median OR. Results: At 3,420 hospitals, we identified 264,970 eligible patients. A minority of hospitals (n = 1,446; 38%) performed cardiac surgery, but these hospitals cared for the majority (n = 242,875; 92%) of all eligible patients. Subsequent analyses were limited to these hospitals. The median risk-standardized CR enrollment rate was low (22%) and varied 10-fold across hospitals (10th, 90th percentile: 3%, 42%). Factors associated with higher hospital performance were Midwest location, higher number of hospital beds, directly affiliated CR program, and <1 mile distance between the hospital and closest CR facility. The national hospital median OR was 2.1. Conclusions: The treating hospital plays a key role in facilitating CR enrollment after discharge. Fewer than 1% of U.S. hospitals achieved a risk-standardized CR enrollment rate of >70%. Hospitals with cardiac surgery capability care for more than 90% of all CR-eligible patients and may be a logical place to focus improvement efforts.","journal":"JACC Advances","year":2024,"id":429442,"datarank":0.3453877639491069,"base_score":2.302585092994046,"endowment":2.302585092994046,"self_citation_contribution":0.3453877639491069,"citation_network_contribution":0.0,"self_endowment_contribution":0.3453877639491069,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":9,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.8347,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1232106,"name":"Taylor Keys","orcid":null,"position":1,"is_corresponding":false},{"id":323690,"name":"Aruna Priya","orcid":"0000-0002-2431-0543","position":2,"is_corresponding":false},{"id":323692,"name":"Penelope S. Pekow","orcid":"0000-0002-0180-1710","position":3,"is_corresponding":false},{"id":234098,"name":"Steven J. Keteyian","orcid":null,"position":4,"is_corresponding":false},{"id":502855,"name":"Michael P. Thompson","orcid":"0000-0002-9992-593X","position":5,"is_corresponding":false},{"id":1157106,"name":"Thomas D’Aunno","orcid":null,"position":6,"is_corresponding":false},{"id":323695,"name":"Peter K. Lindenauer","orcid":"0000-0002-8414-0507","position":7,"is_corresponding":false},{"id":316808,"name":"Tara Lagu","orcid":"0000-0001-6155-5796","position":8,"is_corresponding":false},{"id":323691,"name":"Quinn R. Pack","orcid":"0000-0002-2631-242X","position":0,"is_corresponding":true}],"reference_count":36,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T01:59:06.668462Z","pmid":"39741644","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}