Financial Incentives to Increase Cardiac Rehabilitation Participation Among Low-Socioeconomic Status Patients
| Autor: | Rebecca J. Elliott, Stephen T. Higgins, Diann E. Gaalema, Jeff S. Priest, Alex Y. Cutler, Jason L. Rengo, Patrick D. Savage, Philip A. Ades, Donald S. Shepard, Irene Pericot-Valverde |
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| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Rehabilitation business.industry medicine.medical_treatment Emergency department 030204 cardiovascular system & hematology law.invention 03 medical and health sciences 0302 clinical medicine Quality of life Randomized controlled trial law Physical therapy medicine 030212 general & internal medicine Patient participation Cardiology and Cardiovascular Medicine business Medicaid Socioeconomic status Body mass index |
| Zdroj: | JACC: Heart Failure. 7:537-546 |
| ISSN: | 2213-1779 |
| DOI: | 10.1016/j.jchf.2018.12.008 |
| Popis: | Objectives This study sought to examine the efficacy of financial incentives to increase Medicaid patient participation in and completion of cardiac rehabilitation (CR). Background Participation in CR reduces morbidity, mortality, and hospitalizations while improving quality of life. Lower-socioeconomic status (SES) patients are much less likely to attend and complete CR, despite being at increased risk for recurrent cardiovascular events. Methods A total of 130 individuals enrolled in Medicaid with a CR-qualifying cardiac event were randomized 1:1 to receive financial incentives on an escalating schedule ($4 to $50) for completing CR sessions or to receive usual care. Primary outcomes were CR participation (number of sessions completed) and completion (≥30 sessions completed). Secondary outcomes included changes in sociocognitive measurements (depressive/anxious symptoms, executive function), body composition (waist circumference, body mass index), fitness (peak VO2) over 4 months, and combined number of hospitalizations and emergency department (ED) contacts over 1 year. Results Patients randomized to the incentive condition completed more sessions (22.4 vs. 14.7, respectively; p = 0.013) and were almost twice as likely to complete CR (55.4% vs. 29.2%, respectively; p = 0.002) as controls. Incentivized patients were also more likely to experience improvements in executive function (p Conclusions Financial incentives improve CR participation among lower-SES patients following a cardiac event. Increasing participation among lower-SES patients in CR is critical for positive longer-term health outcomes. (Increasing Cardiac Rehabilitation Participation Among Medicaid Enrollees; NCT02172820) |
| Databáze: | OpenAIRE |
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