Background: Because delays can result in significant patient deterioration, a CCS working group recently set benchmarks for safe wait times for access to cardiac rehabilitation (CR). They concluded that acceptable wait times vary from 7-60 days from cardiac event to CR intake. The current study audited individual patient CR delays from referral to intake.

Methods: As part of a larger study, self-reported CR utilization of 668 coronary artery disease outpatients recruited through 97 Ontario cardiologists was verified with 41 CR sites in Ontario. CR sites reported date of referral receipt and patient intake, as well as any delays (yes/no, and reason).

Results: The mean time from CR referral receipt to intake was 60.0 +/- 72.7 days, with a median of 43 days. A delay was reported for 50 (14.1%) patients, with a mean delay of 117.8 +/- 102.9 days for those with vs 50.7 +/- 64.6 for those without delay (P < .001). Reasons cited for delays were as follows: program capacity issues leading to a waiting list (n = 17, 37.0%; median 133 days delay), awaiting test results or physician response (n = 11, 23.9%; median 77.5 days), patient unavailability due to vacation or work for example (n = 6, 13.0%; median 80 days), patient health (n = 4, 8.7%; median 90 days), other reasons (n = 8, 17.4%), and 4 reasons were unknown.

Conclusions: Data from the 2002 CR Pilot Project reported a median delay of 31 days from patient referral to intake, suggesting improvements have not been realized over time. The most frequent and the longest cause of delays were health-system related, specifically capacity issues. Clearly increased funding to ensure timely access to CR for more Ontarians is imperative.