Nature and delivery of cardiac rehabilitation in New Zealand: Are services equitable to other high-income countries?

Abstract

Aims: To compare the nature and delivery of cardiac rehabilitation (CR) services within New Zealand by island (North vs South; NI, SI), and to other high-income countries (HICs).

Methods: In this cross-sectional study, secondary analysis of an online survey of CR programmes globally was undertaken. Results from New Zealand were compared to data from other HICs with CR.

Results: Twenty-seven (62.7%) out of 43 CR programmes in New Zealand (n=18/31, 66.7% respondents from NI) and 619 (43.1%) from 28 other HICs completed the survey. New Zealand CR programmes offered a median of 16.0 sessions/patient (interquartile range (IQR)=12.0-36.0; vs 21.6 sessions in other HICs, IQR=12.0-36.0, p=0.016), delivered by a team of 6.0 staff (IQR=5.5-7.0; vs 7.0 staff; IQR=5.0-9.0, p=0.012). New Zealand programmes were significantly less comprehensive than other HICs (p=0.002); within New Zealand, NI programmes were more likely to provide an initial and end-of-programme assessment, supervised exercise training and depression screening, compared to SI programmes (all p<0.05). New Zealand more often offered CR in an alternative setting (n=14, 58.3%), compared to other HICs (n=190, 36.5%), p=0.03).

Conclusions: CR programmes in New Zealand offer fewer sessions and have fewer elements compared to other HICs, and disparity exists in programmes across New Zealand. More investment is needed to ensure CR in New Zealand meets international guidelines.