{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T22:14:03Z","timestamp":1791670443380,"version":"4.3.4"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Heart Failure"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Coverage for cardiac rehabilitation (CR) for patients with heart failure with reduced ejection fraction was expanded in 2014, but contemporary referral and participation rates remain unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>Patients hospitalized for heart failure with reduced ejection fraction (\u226435%) in the American Heart Association Get With The Guidelines\u2013Heart Failure registry from 2010 to 2020 were included, and CR referral status was described as yes, no, or not captured. Temporal trends in CR referral were assessed in the overall cohort. Patient and hospital-level predictors of CR referral were assessed using multivariable-adjusted logistic regression models. Additionally, CR referral and proportional utilization of CR within 1-year of referral were evaluated among patients aged &gt;65 years with available Medicare administrative claims data who were clinically stable for 6-weeks postdischarge. Finally, the association of CR referral with the risk of 1-year death and readmission was evaluated using multivariable-adjusted Cox models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Of 69,441 patients with heart failure with reduced ejection fraction who were eligible for CR (median age 67 years; 33% women; 30% Black), 17,076 (24.6%) were referred to CR, and referral rates increased from 8.1% in 2010 to 24.1% in 2020 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      <jats:sub>trend<\/jats:sub>\n                      &lt;0.001). Of 8310 patients with Medicare who remained clinically stable 6-weeks after discharge, the CR referral rate was 25.8%, and utilization of CR among referred patients was 4.1% (mean sessions attended: 6.7). Patients not referred were more likely to be older, of Black race, and with a higher burden of comorbidities. In adjusted analysis, eligible patients with heart failure with reduced ejection fraction who were referred to CR (versus not referred) had a lower risk of 1-year death (hazard ratio, 0.84 [95% CI, 0.70\u20131.00];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.049) without significant differences in 1-year readmission.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>CR referral rates have increased from 2010 to 2020. However, only 1 in 4 patients are referred to CR. Among eligible patients who received CR referral, participation was low, with &lt;1 of 20 participating in CR.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circheartfailure.122.010144","type":"journal-article","created":{"date-parts":[[2023,7,11]],"date-time":"2023-07-11T05:00:18Z","timestamp":1689051618000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":26,"title":["Patterns of Referral and Postdischarge Utilization of Cardiac Rehabilitation Among Patients Hospitalized With Heart Failure: An Analysis From the GWTG-HF Registry"],"prefix":"10.1161","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6890-8670","authenticated-orcid":true,"given":"Neil","family":"Keshvani","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Medicine, UT Southwestern Medical Center, Dallas, TX (N.K., V.S., A.P.)."},{"name":"Parkland Health and Hospital System, Dallas, TX (N.K., V.S., A.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinayak","family":"Subramanian","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, UT Southwestern Medical Center, Dallas, TX (N.K., V.S., A.P.)."},{"name":"Parkland Health and Hospital System, Dallas, TX (N.K., V.S., A.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher A.","family":"Wrobel","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Duke University Medical Center, Durham, NC (C.A.W., S.J.G., A.D.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5643-9958","authenticated-orcid":true,"given":"Nicole","family":"Solomon","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Durham, NC (N.S., B.A., S.J.G., A.D.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4243-8062","authenticated-orcid":true,"given":"Brooke","family":"Alhanti","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Durham, NC (N.S., B.A., S.J.G., A.D.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6912-7374","authenticated-orcid":true,"given":"Stephen J.","family":"Greene","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Duke University Medical Center, Durham, NC (C.A.W., S.J.G., A.D.D.)."},{"name":"Duke Clinical Research Institute, Durham, NC (N.S., B.A., S.J.G., A.D.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4679-2221","authenticated-orcid":true,"given":"Adam D.","family":"DeVore","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Duke University Medical Center, Durham, NC (C.A.W., S.J.G., A.D.D.)."},{"name":"Duke Clinical Research Institute, Durham, NC (N.S., B.A., S.J.G., A.D.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7271-4166","authenticated-orcid":true,"given":"Clyde W.","family":"Yancy","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Feinberg School of Medicine, Northwestern University, Chicago, IL (C.W.Y.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2540-3095","authenticated-orcid":true,"given":"Larry A.","family":"Allen","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University of Colorado Medical Center, Aurora (L.A.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3192-8093","authenticated-orcid":true,"given":"Gregg C.","family":"Fonarow","sequence":"additional","affiliation":[{"name":"Ronald Reagan-UCLA Medical Center, Los Angeles, CA 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