The Health care Atlas for myocardial infarction contains two parts: 1) an update of results from the Elderly Health Atlas with admissions for myocardial infarction and revascularization, and 2) rehabilitation after myocardial infarction.
Rehabilitation in specialist health services is examined in two ways: 1) activity registered with rehabilitation codes; here called standard rehabilitation, and 2) standard rehabilitation plus activity registered as learning and mastery courses and/or training.
The analyses are based on data from the Norwegian Patient Register and Norwegian Registry for Primary Health Care (KPR) for the period 2018-2022.
Main Findings
- In the period 2018-2022, only 14% of patients received standard rehabilitation after an acute myocardial infarction in Norway, despite well-documented effects of cardiac rehabilitation.
- Approximately one out of every four patients received standard rehabilitation, learning and mastery courses (LMC), or training in specialist health services after an acute myocardial infarction. The percentage receiving rehabilitation after a myocardial infarction was significantly lower for patients aged 65 and older.·
- There was significant and unwarranted geographical variation in the use of rehabilitation after myocardial infarction. . For those who received rehabilitation, the extent, content, organization, and time after the infarction when rehabilitation started varied.
- The number of elderly (75 years and older) admitted with acute myocardial infarction has decreased, despite an increase in the elderly population.
- There was little geographical variation in the number of patients admitted with acute myocardial infarction per 1,000 population, excluding the areas with the highest and lowest rates.·
- There was moderate geographical variation in revascularization rates for the elderly (75 years and older), and little variation for the general population (18 years and older).
- As in 2013-2015, there was no correlation between admission for acute myocardial infarction and revascularization of the heart for the elderly (75 years and older). For all adults (18 years and older), the correlation was moderate. There were greater geographical variations in treatment practices for the elderly than for all adults combined.
Patients with Myocardial Infarction
Main Findings:·
- The number of elderly admitted with acute myocardial infarction has decreased, despite an increase in the elderly population.
- The admission rate for myocardial infarction was highest in the Finnmark catchment area. This indicates that the prevalence of myocardial infarction is higher in Finnmark than in the rest of the country.
- The geographical variation in admissions for myocardial infarction was small when excluding the referral areas with the highest (Finnmark) and lowest rates (Diakonhjemmet area/Oslo West).
Revascularization
- The geographical variation in revascularization rates was moderate when looking at the elderly (75 years and older) in isolation, and small for the general population.
- The admission rate for myocardial infarction did not correlate with the revascularization rate for the elderly (75 years and older). For all adults combined (18 years and older), the correlation was moderate.
- The majority (77%) of patients who were revascularized were men.
Rehabilitation
- In the period 2018-2022, only 14% of patients received standard rehabilitation after an acute myocardial infarction in Norway, despite well-documented effects of cardiac rehabilitation.
- 26% of patients received standard rehabilitation, learning and mastery courses (LMC), or training in specialist health services after an acute heart attack.
- There was significant geographical variation in the use of rehabilitation after myocardial infarction, even when LMC and training in specialist health services were included in the analyses.
- Few elderly patients received rehabilitation after myocardial infarction.
- Content, organization, and start time varied geographically.
Training with Physiotherapists in Municipalities
Four percent of patients trained with physiotherapists in the municipalities in the first six months after an acute myocardial infarction in 2018-2021. There was significant geographical variation in training with physiotherapists.
Do you have questions?
For questions or comments, please contact the Health Atlas Service at Helse Førde HF through [helseatlas@helse-forde.no].