{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T23:33:41Z","timestamp":1787960021012,"version":"build-2784847793"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"16","license":[{"start":{"date-parts":[[2020,3,25]],"date-time":"2020-03-25T00:00:00Z","timestamp":1585094400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Eur J Prev Cardiolog"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Despite its role as an effective intervention to improve the long-term health of patients with cardiovascular disease and existence of national guidelines on timeliness, many health services still fail to offer cardiac rehabilitation in a timely manner after referral. The impact of this failure on patient health and the additional burden on healthcare providers in an English setting is quantified in this article.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Two logistic regressions are conducted, using the British Heart Foundation National Audit of Cardiac Rehabilitation dataset, to estimate the impact of delayed cardiac rehabilitation initiation on the level of uptake and completion. The results of these regressions are applied to a decision model to estimate the long-term implications of these factors on patient health and National Health Service expenditure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We demonstrate that the failure of 43.6% of patients in England to start cardiac rehabilitation within the recommended timeframe results in a 15.3% reduction in uptake, and 7.4% in completion. These combine to cause an average lifetime loss of 0.08 years of life expectancy per person. Scaled up to an annual cohort this implies 10,753 patients not taking up cardiac rehabilitation due to the delay, equating to a loss of 3936 years of life expectancy. We estimate that an additional \u00a312.3 million of National Health Service funding could be invested to alleviate the current delay.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The current delay in many patients starting cardiac rehabilitation is causing quantifiable and avoidable harm to their long-term health; policy and research must now look at both supply and demand solutions in tackling this issue.<\/jats:p><\/jats:sec>","DOI":"10.1177\/2047487320912625","type":"journal-article","created":{"date-parts":[[2020,3,26]],"date-time":"2020-03-26T04:05:33Z","timestamp":1585195533000},"page":"1775-1781","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":17,"title":["Quantifying the impact of delayed delivery of cardiac rehabilitation on patients\u2019 health"],"prefix":"10.1093","volume":"27","author":[{"given":"Sebastian","family":"Hinde","sequence":"first","affiliation":[{"name":"Centre for Health Economics, University of York, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Harrison","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of York, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Bojke","sequence":"additional","affiliation":[{"name":"Centre for Health Economics, University of York, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Doherty","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of York, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,3,25]]},"reference":[{"key":"bibr3-2047487320912625","volume-title":"The Global Economic Burden of Noncommunicable Diseases","author":"Bloom DE","year":"2011"},{"key":"bibr4-2047487320912625","volume-title":"Prevention of Cardiovascular Disease","author":"World Health Organization","year":"2007"},{"key":"bibr5-2047487320912625","volume-title":"The BACPR Standards and Core Components for Cardiovascular Disease Prevention and Rehabilitation","author":"British Association for Cardiovascular Prevention and Rehabilitation (BACPR).","year":"2017"},{"key":"bibr6-2047487320912625","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.10.044"},{"key":"bibr8-2047487320912625","unstructured":"National Institute for Health and Care Excellence (NICE). Myocardial infarction: cardiac rehabilitation and prevention of further cardiovascular disease. London: NICE, 2013; CG172."},{"key":"bibr9-2047487320912625","volume-title":"Turning Back the Tide on Heart and Circulatory Disease","author":"British Heart Foudation.","year":"2018"},{"key":"bibr10-2047487320912625","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.112.121996"},{"key":"bibr11-2047487320912625","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2010.12.076"},{"key":"bibr12-2047487320912625","doi-asserted-by":"publisher","DOI":"10.1097\/HCR.0b013e318228a32f"},{"key":"bibr13-2047487320912625","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.115.001751"},{"key":"bibr14-2047487320912625","doi-asserted-by":"publisher","DOI":"10.1136\/openhrt-2015-000369"},{"key":"bibr15-2047487320912625","doi-asserted-by":"publisher","DOI":"10.1177\/2047487317740951"},{"key":"bibr16-2047487320912625","doi-asserted-by":"publisher","DOI":"10.1177\/2047487317717064"},{"key":"bibr17-2047487320912625","volume-title":"The National Audit of Cardiac Rehabilitation: Annual Statistical Report 2018","author":"British Heart Foudation","year":"2018"},{"key":"bibr18-2047487320912625","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehx493.5972"},{"key":"bibr19-2047487320912625","doi-asserted-by":"crossref","DOI":"10.1093\/oso\/9780198526629.001.0001","volume-title":"Decision modelling for health economic evaluation","author":"Briggs A","year":"2006"},{"key":"bibr20-2047487320912625","doi-asserted-by":"publisher","DOI":"10.3310\/hta19140"},{"key":"bibr21-2047487320912625","doi-asserted-by":"publisher","DOI":"10.1177\/2047487312449597"}],"container-title":["European Journal of Preventive Cardiology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2047487320912625","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/2047487320912625","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2047487320912625","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,2]],"date-time":"2024-08-02T22:29:56Z","timestamp":1722637796000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eurjpc\/article\/27\/16\/1775-1781\/5950917"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,3,25]]},"references-count":18,"journal-issue":{"issue":"16","published-print":{"date-parts":[[2020,11]]}},"alternative-id":["10.1177\/2047487320912625"],"URL":"https:\/\/doi.org\/10.1177\/2047487320912625","relation":{},"ISSN":["2047-4873","2047-4881"],"issn-type":[{"value":"2047-4873","type":"print"},{"value":"2047-4881","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,3,25]]}}}