Cardiac rehabilitation services in Ireland: the impact of a coordinated national development strategy.
BACKGROUND: The national Cardiovascular Health Strategy including specific plans for cardiac rehabilitation was launched in Ireland in 1999. A survey of cardiac rehabilitation services was conducted in 2003 to evaluate progress on service provision. AIM: To establish levels of service provision, service formats and geographic distribution of cardiac rehabilitation services in 2003 and compare them with the status pre-Strategy (1998). METHOD: All hospitals in Ireland (n = 39) admitting cardiac patients to a coronary or intensive care unit were surveyed by postal questionnaire. RESULTS: All hospitals provided information and all reported providing Phase I cardiac rehabilitation. Seventy-seven per cent (30 of 39) provided Phase III rehabilitation in 2003 (i.e. outpatient cardiac rehabilitation services) compared with 29% (12 of 41) in 1998. Of those hospitals currently without programmes, 78% (seven of nine) had plans in place for programme establishment. All programmes had trained cardiac rehabilitation coordinators, multidisciplinary teams and multiple components as recommended in the Strategy. In 82% of hospitals, intervention was provided at Phase II (immediate post-discharge period) while 26% of hospitals provided intervention at Phase IV (long-term maintenance period). CONCLUSIONS: There have been substantial achievements towards the Cardiovascular Health Strategy target of providing cardiac rehabilitation services for all relevant hospitals in Ireland over the past five years. Service provision of cardiac rehabilitation can benefit from collective efforts made across centres to encourage the prioritisation of cardiac rehabilitation in national health policy initiatives.