Primary care provider receipt of cardiac rehabilitation discharge summaries: are they getting what they want to promote long-term risk reduction?

摘要

Communication between cardiac rehabilitation (CR) and primary care providers (PCPs) is paramount to promoting long-term risk reduction after the completion of CR. The objectives of this study were to investigate receipt of CR discharge summaries by PCPs, as well as timing, and satisfaction with and perceptions of CR summaries.Five hundred seventy-seven eligible PCPs of consenting enrollees from 8 regional or urban Ontario CR programs were invited to participate in this cross-sectional study. Discharge summaries were tracked from the CR program to the PCP's office. PCPs who received a summary were mailed a survey assessing their perceptions of the summaries. Of the 138 (24.0%) eligible consenting PCPs, 71 (51.5%) received CR discharge summary, of whom 64 (90.1%) completed the survey. All PCPs desired to receive discharge summaries, with most wanting it transmitted via fax (n=38, 61.3%). Forty-seven (77.1%) PCPs reported they had or will use information in the summary for patient care. PCPs who did not receive the discharge summary in advance of their patient's first post-CR visit (n=7, 10.9%) were significantly less likely to use it in patient care (P<0.01). On a 5-point Likert scale, PCPs rated medication (4.65±0.74), patient care plan (4.43±0.87), and clinical status (4.33±0.94) as most important to include in a CR discharge summary. These were not provided in 18.8% (n=12), 4.7% (n=3), and 22.2% (n=14) of summaries, respectively.Approximately half of CR discharge summaries reach PCPs, revealing a large gap in continuity of patient care.