{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T09:03:40Z","timestamp":1792573420801,"version":"4.5.0"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Quality and Outcomes"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Despite reported benefit in the setting of aortic valve replacement (AVR), cardiac rehabilitation (CR) utilization remains low, with few studies evaluating hospital and patient-level variation in CR participation. We explored determinants of CR variability during AVR episodes of care: transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>A cohort of 10 124 AVR episodes of care (TAVR n=5121 from 24 hospitals; SAVR n=5003 from 32 hospitals) were identified from the Michigan Value Collaborative statewide multipayer registry (2015\u20132019). CR enrollment was defined as the presence of a single professional or facility claim within 90 days of discharge: 93 797, 93 798, G0422, G0423. Annual trends and hospital variation in CR were described for TAVR, SAVR, and all AVR. Multilevel logistic regression was used to estimate effects of predictors and hospital risk-adjusted rates of CR enrollment.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              Overall, 4027 (39.8%) patients enrolled in CR, with significant differences by treatment strategy: SAVR=50.9%, TAVR=28.9% (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). CR use after SAVR was significantly higher than after TAVR and increased over time for both modalities (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). There were significant differences in CR enrollment across age, gender, payer, and some comorbidities (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.05). At the hospital level, CR participation rates for all AVR varied 10-fold (4.8% to 68.7%) and were moderately correlated between SAVR and TAVR (Pearson\n              <jats:italic>r<\/jats:italic>\n              =0.56,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.01).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Substantial variation exists in CR participation during AVR episodes of care across hospitals. However, within-hospital CR participation rates were significantly correlated across treatment strategies. These findings suggest that CR participation is the product of hospital-specific practice patterns. Identifying hospital practices associated with higher CR participation can help assist future quality improvement efforts to increase CR use after AVR.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circoutcomes.122.009175","type":"journal-article","created":{"date-parts":[[2022,5,13]],"date-time":"2022-05-13T15:45:09Z","timestamp":1652456709000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["Variation in Cardiac Rehabilitation Participation During Aortic Valve Replacement Episodes of Care"],"prefix":"10.1161","volume":"15","author":[{"given":"Vinay","family":"Guduguntla","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, University of California, San Francisco (V.G.)."},{"name":"Michigan Value Collaborative, University of Michigan, Ann Arbor (V.G., J.M.Y., M.P.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica M.","family":"Yaser","sequence":"additional","affiliation":[{"name":"Michigan Value Collaborative, University of Michigan, Ann Arbor (V.G., J.M.Y., M.P.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven J.","family":"Keteyian","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Henry Ford Health, Detroit, MI (S.J.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis D.","family":"Pagani","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Michigan Medicine, Ann Arbor (F.D.P., D.S.L., M.P.T.)."},{"name":"Michigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative, Ann Arbor, MI (F.D.P., D.S.L., M.P.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0416-9359","authenticated-orcid":true,"given":"Donald S.","family":"Likosky","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Michigan Medicine, Ann Arbor (F.D.P., D.S.L., M.P.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4709-3390","authenticated-orcid":true,"given":"Devraj","family":"Sukul","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of California, San Francisco (V.G.)."},{"name":"Division of Cardiovascular Medicine, Department of Internal Medicine, Michigan Medicine, Ann Arbor (D.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9992-593X","authenticated-orcid":true,"given":"Michael P.","family":"Thompson","sequence":"additional","affiliation":[{"name":"Michigan Value Collaborative, University of Michigan, Ann Arbor (V.G., J.M.Y., M.P.T.)."},{"name":"Department of Cardiac Surgery, Michigan Medicine, Ann Arbor (F.D.P., D.S.L., M.P.T.)."},{"name":"Michigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative, Ann Arbor, MI (F.D.P., D.S.L., M.P.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmrj.2011.06.007"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2016-309414"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2016-309414"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/2047487316686442"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2019.4032"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/HCR.0000000000000208"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/2047487313494029"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.11909\/j.issn.1671-5411.2014.04.001"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40119-020-00186-3"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.01.001"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehi426"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.119.005902"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/HCR.0000000000000210"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.120.007144"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2017.2881"},{"key":"e_1_3_3_17_2","first-page":"e382","article-title":"Validation of a claims-based algorithm to characterize episodes of care.","volume":"23","author":"Ellimoottil C","year":"2017","unstructured":"Ellimoottil, C, Syrjamaki, JD, Voit, B, Guduguntla, V, Miller, DC, Dupree, JM. 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