{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T16:17:17Z","timestamp":1784132237433,"version":"3.55.0"},"reference-count":35,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2020,4,9]],"date-time":"2020-04-09T00:00:00Z","timestamp":1586390400000},"content-version":"unspecified","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007405","name":"the Danish Heart Foundation","doi-asserted-by":"crossref","award":["18-R123-A8283-22081"],"award-info":[{"award-number":["18-R123-A8283-22081"]}],"id":[{"id":"10.13039\/100007405","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Karen Elise Jensens Foundation"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2020,3,9]]},"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To evaluate the association between socioeconomic status (SES) and referral to cardiac rehabilitation (CR) after incident acute coronary syndrome (ACS) by dividing the referral process into three phases: (1) informed about CR, (2) willingness to participate in CR, (3) and assigned CR setting.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Cross-sectional study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>Department of Cardiology at a Danish University Hospital from 1 January 2011 to 31 December 2014.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>A total of 1229 patients assessed for CR during hospitalisation with ACS were prospectively registered in the Rehab-North Register from 2011 to 2014. SES was assessed using data from national registers, concerning: personal income, occupational status, educational level and civil status. Patients were excluded if one of the following criteria was fulfilled: (1) missing data on SES, or (2) acceptable reason for not informing patients about CR (treatment with coronary artery bypass grafting, transfer to another hospital, still under treatment or death).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main outcome measures<\/jats:title>\n                  <jats:p>Outcomes were defined by dividing the referral process into three phases: (1) informed about CR, (2) willingness to participate, and (3) assigned CR setting (in-hospital\/community centre) after ACS.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 854 (69.5 %) patients were referred to CR. After adjustment for age, gender, ACS diagnosis (ST-elevated myocardial infarction, non-ST-elevated myocardial infarction, unstable angina pectoris) and comorbidity, high income had the strongest association of referral to CR in all three phases (informed about CR: OR 2.17, 95%\u2009CI 1.01 to 4.64; willingness to participate in CR: OR 1.55, 95%\u2009CI 1.02 to 2.35; assigned in-hospital CR: OR 1.47, 95%\u2009CI 0.91 to 2.36). Educational level showed similar tendencies, however not statistically significant. The results did not vary according to gender.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>This is the first study to investigate the referral process to CR using a three-phase structure. It suggests income and education to influence all phases in the referral process to CR after ACS.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2019-036088","type":"journal-article","created":{"date-parts":[[2020,4,10]],"date-time":"2020-04-10T03:49:29Z","timestamp":1586490569000},"page":"e036088","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":26,"title":["Influence of socioeconomic status on the referral process to cardiac rehabilitation following acute coronary syndrome: a cross-sectional study"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9199-6418","authenticated-orcid":false,"given":"Christina Boesgaard","family":"Graversen","sequence":"first","affiliation":[{"name":"Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin Berg","family":"Johansen","sequence":"additional","affiliation":[{"name":"Unit of Clinical Biostatistics, Aalborg University Hospital, Aalborg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Regina","family":"Eichhorst","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Slagelse Hospital, Slagelse, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00f8ren Paaske","family":"Johnsen","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, Danish Center for Clinical Health Services Research, Aalborg University, Aalborg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sam","family":"Riahi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark"},{"name":"Department of Clinical Medicine, Aalborg University, Aalborg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Holmberg","sequence":"additional","affiliation":[{"name":"National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mogens Lytken","family":"Larsen","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, Aalborg University, Aalborg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,4,9]]},"reference":[{"key":"2025101813395158000_10.4.e036088.1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000228"},{"key":"2025101813395158000_10.4.e036088.2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.029652"},{"key":"2025101813395158000_10.4.e036088.3","doi-asserted-by":"crossref","first-page":"985","DOI":"10.1177\/2047487318766646","article-title":"Socioeconomic status predicts second 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