Substantial hospital-level variation seen, not explained by patient case mix
By Lori Solomon HealthDay Reporter
MONDAY, Oct. 16, 2023 (HealthDay News) — Less than one-third of patients who undergo transcatheter aortic valve replacement (TAVR) appear to participate in cardiac rehabilitation (CR) within 90 days of discharge, according to a study published online Oct. 2 in JACC: Advances.
Devraj Sukul, M.D., from the University of Michigan in Ann Arbor, and colleagues characterized patient and hospital factors associated with CR participation after TAVR and examined which factors explain hospital-level variation in CR participation. The analysis included clinical and administrative claims data from 3,372 patients who underwent TAVR at 24 Michigan hospitals (Jan. 1, 2016, to June 30, 2020).
The researchers found that 30.6 percent participated in CR within 90 days after discharge. Patient factors negatively associated with CR participation included older age, Medicaid insurance, atrial fibrillation/flutter, dialysis use, and slower baseline five-minute walk times. CR participation after TAVR substantially varied by hospital, ranging from 5 to 60 percent. Hospital variation was not explained by patient case mix.
“With the continued growth of TAVR for the treatment of severe aortic stenosis and concomitant improvements in postprocedural outcomes due to periprocedural care innovations, including the use of moderate sedation and same-day discharge, we highlight an important gap in the postdischarge care of this ever-growing population of patients,” the authors write.
Several authors disclosed ties to industry.
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