Home-Based Cardiac Rehab Availability Tied to Higher Participation in Veterans

Veterans with ischemic heart disease (IHD) treated at Veterans Affairs (VA) facilities offering home-based cardiac rehabilitation (HBCR) were more likely to participate in cardiac rehabilitation (CR) than those at facilities offering only center-based programs or referral to community care, according to a cohort study published in JAMA Network Open.

Investigators used national Veterans Health Administration electronic health record data on 405,907 veterans hospitalized for acute myocardial infarction, percutaneous coronary intervention, or coronary artery bypass graft surgery from 2012 to 2022 (mean age, 68.5 years; 96.6% men). The primary outcome was participation in any type of CR within 12 months of the index event. Facilities were grouped as offering HBCR, center-based CR (CBCR) without HBCR, or referral to community care only.

Overall, 15.6% of veterans participated in CR. Participation increased from 9.6% in 2012 to 17.1% in 2022, peaking at 19.7% in 2018, while the number of VA facilities offering HBCR rose from 3 to 52. In 2022, participation was 20.0% at facilities offering HBCR, 14.8% at those offering CBCR without HBCR, and 14.3% at those offering community care referral only. Compared with community care referral only, the adjusted odds ratio (AOR) of participation was 1.80 (95% CI, 1.75-1.84) at HBCR facilities and 1.29 (95% CI, 1.26-1.32) at CBCR facilities.

Veterans who participated were more likely to be younger, male, White, married, and of higher socioeconomic status, which the authors said highlights persistent disparities in utilization. After the COVID-19 period was excluded, the AOR at HBCR facilities was 2.10 (95% CI, 2.03-2.16).

The authors noted that the findings cannot be interpreted as causal because unmeasured facility characteristics, such as leadership or referral culture, may have contributed, and that they could not determine which type of CR individual patients received. They concluded that broader availability of HBCR programs may help improve participation within large health systems.

Source: Park LG, Zhang N, Schopfer DW, et al. Home-based programs and cardiac rehabilitation participation among veterans with ischemic heart disease. JAMA Netw Open. 2026;9(10):e2638356. doi:10.1001/jamanetworkopen.2026.38356