Victorian Registry Data Shows Cardiac Rehab Non-Attendance Quadruples One-Year Cardiac Mortality

{"The Monash-led study merged the Victorian Cardiac Outcomes Registry with outpatient records across 13 public hospitals, classifying patients as non-attenders, low attenders (1-5 sessions), or high attenders (≥6 sessions). High attenders were younger, more often lived with family, and had longer index admissions, yet overall uptake remained 19.3 percent. Mortality and unplanned readmissions declined in a dose-dependent manner with each additional session attended.","Referral failure emerges as the dominant barrier: earlier VCOR analyses showed 85 percent of PCI patients received referrals, yet fewer than one-fifth reached programs. This gap reflects fragmented inpatient-to-outpatient handoffs, absence of a national cardiac rehabilitation registry, and lack of systematic follow-up, patterns also documented in US and UK audits where referral alone fails to convert into enrollment without active navigation.","Australia's underuse mirrors global shortfalls but is compounded by the lack of mandatory performance metrics that countries such as the UK and Denmark apply to drive participation above 50 percent. Socioeconomic and geographic disparities likely widen the observed gradients, though the registry linkage did not capture private-hospital or rural cohorts.","Next steps require automated referral-plus-enrollment pathways and a national registry to enable benchmarking; without these, the fourfold mortality differential will persist across successive annual cohorts."}