The demand for outpatient cardiologic rehabilitation (OCR) within areas oflarge cities. Results of the Cologne model of OCR-Phase II

Within the Cologne Model (CM) of outdoor cardiac rehabilitation (OCR), phas e II investigations about the demand for this form of cardiac rehabilitatio n (CR) after acute cardiac diseases were carried out in three general hospi tals, the cardiological and cardiosurgical university hospitals of Cologne. The subsequent questions were investigated: total number of coronary or ca rdiac operated patients, number of patients with indication for CR, and num ber of patients corresponding to the restricted indications of CM (age belo w 65, low risk patient, no cardiac operation). For these groups the accepta nce or refusal of CR was checked. Subsequently a sample of patients corresp onding to the criteria of CM or of operated patients were confronted with t he additional offer of an OCR. The motivation for the acceptance of rehabil itation in specialized hospitals (ICR), OCR or refusal of each kind of CR w as inquired. The acceptance of CR in the different groups varied widely. Whereas operate d patients in Cologne accept CR in nearly 100 % of cases, this is the case in patients after acute myocardial infarction (AMI) in only 50 % and in pat ients after PTCA without AMI in only 5-6 %. The analysis of predictors for acceptance brings about that younger patients prefer CR, and if they do, OC R. Patients with the more serious form of disease prefer ICR. Women accept CR more rarely than men, and if they do, they prefer the hospital form. How ever, this is less gender specific but consequence of the generally more se rious form and later onset of CAD in females. Higher educational as well as occupational status favors acceptance of CR and specially OCR. The suspici ons that unmarried people prefer OCR and foreigners ICR could not be genera lly confirmed. Crucial reasons for the form of CR which is accepted or refu sed are individual ones. ICR is favored by the wish for more safety and bet ter recuperation. For OCR, the comfortable conditions at home with high soc ial support and/or antipathy against hospitals after long clinical treatmen t are named. Analysis of demand for OCR demonstrates that between 40 % in low risk patie nts (corresponding to CM criteria) and 20 % in more serious cases (operated patients) prefer the outhospital form. From these data an estimation of de mand for OCR in areas with high population was carried out.