{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T22:17:44Z","timestamp":1791497864500,"version":"4.3.4"},"reference-count":48,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2018,4,17]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Cardiac rehabilitation (\n                      <jats:styled-content style=\"fixed-case\">CR<\/jats:styled-content>\n                      ) referral is recommended for eligible patients, regardless of sex or race. It is unclear whether inequality in\n                      <jats:styled-content style=\"fixed-case\">CR<\/jats:styled-content>\n                      referral practices was associated with patients\u2019 long\u2010term survival.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      We linked the American Heart Association Get With The Guidelines Coronary Artery Disease registry with Medicare claims data for 48\u00a0993 coronary artery disease patients from 365 hospitals across the United States between 2003 and 2009. We used generalized estimation equations to estimate the association between\n                      <jats:styled-content style=\"fixed-case\">CR<\/jats:styled-content>\n                      referral and mortality accounting for clustering within hospitals. Between 2003 and 2009, only 40% of eligible patients received\n                      <jats:styled-content style=\"fixed-case\">CR<\/jats:styled-content>\n                      referrals. Females were 12% less likely to receive\n                      <jats:styled-content style=\"fixed-case\">CR<\/jats:styled-content>\n                      referral compared with males. Black, Hispanic, and Asian patients were 20%, 36%, and 50% less likely, respectively, to receive\n                      <jats:styled-content style=\"fixed-case\">CR<\/jats:styled-content>\n                      referral than white patients.\n                      <jats:styled-content style=\"fixed-case\">CR<\/jats:styled-content>\n                      referral was associated with 40% lower 3\u2010year all\u2010cause mortality. Women and minorities who received\n                      <jats:styled-content style=\"fixed-case\">CR<\/jats:styled-content>\n                      referral at hospital discharge had significantly lower mortality compared with those who did not (odds ratios=0.61 [95% confidence interval, 0.56\u20130.66] for women, 0.75 [95% confidence interval, 0.63\u20130.88] for black, 0.62 [95% confidence interval, 0.50\u20130.79] for Hispanic, and 0.63 [95% confidence interval, 0.46\u20130.85] for Asian patients). Seven percent of the black versus white mortality gap could potentially be reduced by equitable\n                      <jats:styled-content style=\"fixed-case\">CR<\/jats:styled-content>\n                      referral.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      <jats:styled-content style=\"fixed-case\">CR<\/jats:styled-content>\n                      referral rates at hospital discharge remained low. Gaps in receiving\n                      <jats:styled-content style=\"fixed-case\">CR<\/jats:styled-content>\n                      referral at hospital discharge were large for women and minorities, and the mortality gap could potentially be reduced through elimination of inequality in\n                      <jats:styled-content style=\"fixed-case\">CR<\/jats:styled-content>\n                      referral.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.117.008088","type":"journal-article","created":{"date-parts":[[2018,4,6]],"date-time":"2018-04-06T05:08:09Z","timestamp":1522991289000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":113,"title":["Sex and Racial Disparities in Cardiac Rehabilitation Referral at Hospital Discharge and Gaps in Long\u2010Term Mortality"],"prefix":"10.1161","volume":"7","author":[{"given":"Shanshan","family":"Li","sequence":"first","affiliation":[{"name":"Boston University School of Medicine, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregg C.","family":"Fonarow","sequence":"additional","affiliation":[{"name":"University of California, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"Mukamal","sequence":"additional","affiliation":[{"name":"Beth Israel Deaconess Medical Center, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haolin","family":"Xu","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland A.","family":"Matsouaka","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Durham, NC"},{"name":"Department of Biostatistics and Bioinformatics, Duke University, Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam D.","family":"Devore","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepak L.","family":"Bhatt","sequence":"additional","affiliation":[{"name":"Brigham and Women's Hospital Heart &amp; 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