Danish heart patients' participation in and experience with rehabilitation.

AIM: This study investigated the proportion of Danish patients in cardiac therapy for ischaemic heart disease who participated in cardiac rehabilitation. The study examined differences in patients' participation in and experience and satisfaction with cardiac rehabilitation. METHODS: Data were obtained from a postal questionnaire in a representative sample of patients in therapy for an ischaemic heart disease. Response data were tabulated and analysed by logistic regression. RESULTS: 3% of the patients participated in a complete rehabilitation programme according to Danish standards, 47% of the patients participated in a partial rehabilitation programme, and additionally 32% of the patients participated in a very limited rehabilitation programme. The number of patients participating in a complete rehabilitation programme was low due to the fact that only few patients (and their relatives) received psychological support. The factors living alone and low education are associated with low participation and in particular with receiving psychological support. Elderly (≥50 years) and male patients showed higher satisfaction scores. Patients receiving psychosocial elements in their rehabilitation programme reported higher satisfaction with their rehabilitation. CONCLUSIONS: Few Danish patients with ischaemic heart disease participate in a complete rehabilitation programme mainly due to psychosocial elements not yet being an integral part of cardiac rehabilitation in Denmark. There is a need to differentiate and tailor cardiac rehabilitation to different patient segments, e.g. by gender and age.

Anesthesiologists in prehospital care make a difference to certain groups of patients.

BACKGROUND: Knowledge of the population using prehospital emergency services is scarce except for selected subgroups. Interventions are often made without evaluation. The aim of this study was (1) to describe mortality, hospitalization and the diagnostic pattern among emergency ambulance users and (2) to evaluate the impact of one mobile emergency care unit (MECU) staffed by an anesthesiologist. DESIGN AND METHODS: A descriptive and quasi-experimental study of consecutive emergency ambulance users during two 3-month periods: before the MECU (Period 1) and after (Period 2). Hospitalization, diagnostic and 0-180-day mortality data were requested from national registers. Diagnoses were according to the International Classification of Diseases (ICD). RESULTS: Periods 1 and 2 included 2950 and 2869 users, respectively. The MECU attended 27.7% in Period 2. Fewer users were brought to hospital in Period 2 (87.9% vs. 93.8%, P < 0.0001), especially MECU users (76.5% MECU users vs. 92.3% other users; P < 0.001). Diagnoses included all main ICD-groups. Overall mortality of all users was 10.2%; no difference between the periods. Cardiovascular and respiratory diseases were among the most frequent and were associated with high mortality. In Period 2 mortality was lower in subgroups: acute myocardial infarction (AMI; n = 177, day 0-180, 13.3% vs. 40.5%, P < 0.001); and respiratory diseases, only short-term mortality (n = 388, day 0-1 mortality, 0.0% vs. 2.4%, P < 0.05). CONCLUSION: The diagnostic pattern among emergency ambulance users included all main groups of diseases. After the MECU fewer were brought to hospital. The overall mortality for all ambulance users was not influenced by the MECU. For the subgroups, especially AMI, mortality was lower after the introduction of the MECU.