Regional Variability in the Access to Cardiac Rehabilitation in Poland
Abstract
:1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
- Brewer, L.C.; Kaihoi, B.; Zarling, K.K.; Squires, R.W.; Thomas, R.J.; Kopecky, S.L.; Rawstorn, J.; Wang, P.-C. The Use of Virtual World-Based Cardiac Rehabilitation to Encourage Healthy Lifestyle Choices Among Cardiac Patients: Intervention Development and Pilot Study Protocol. JMIR Res. Protoc. 2015, 4, e39. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Woodruffe, S.; Neubeck, L.; Clark, R.A.; Gray, K.; Ferry, C.; Finan, J.; Sanderson, S.; Briffa, T.G. Australian Cardiovascular Health and Rehabilitation Association (ACRA) Core Components of Cardiovascular Disease Secondary Prevention and Cardiac Rehabilitation 2014. Heart Lung Circ. 2015, 24, 430–441. [Google Scholar] [CrossRef] [PubMed]
- Townsend, N.; Wilson, L.; Bhatnagar, P.; Wickramasinghe, K.; Rayner, M.; Nichols, M. Cardiovascular disease in Europe: Epidemiological update 2016. Eur. Heart J. 2016, 37, 3232–3245. [Google Scholar] [CrossRef] [PubMed]
- Budaj, A. Choroba niedokrwienna serca. In Choroby Wenętrzne. Podręcznik Multimedialny Oparty na Zasadach EBM; Szczeklik, A., Ed.; Rozdział I.F, s. 137; Medycyna Praktyczna: Kraków, Poland, 2005. [Google Scholar]
- Knuuti, J.; Wijns, W.; Saraste, A.; Capodanno, D.; Barbato, E.; Funck-Brentano, C.; Prescott, E.; Storey, R.F.; Deaton, C.; Cuisset, T.; et al. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes. Eur. Heart J. 2019, 41, 407–477. [Google Scholar] [CrossRef] [PubMed]
- Collet, J.-P.; Thiele, H.; Barbato, E.; Barthélémy, O.; Bauersachs, J.; Bhatt, D.L.; Dendale, P.; Dorobantu, M.; Edvardsen, T.; Folliguet, T.; et al. 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur. Heart J. 2020, 1–79. [Google Scholar] [CrossRef]
- Union, E.; OECD. Health at a Glance: Europe 2018; Organisation for Economic Co-Operation and Development (OECD): Paris, France, 2018. [Google Scholar]
- Departament Analiz i Innowacji. NFZ o Zdrowiu. Choroba Niedokrwienna Serca; Centralna Narodowego Funduszu Zdrowia: Warszawa, Poland, 2020.
- OECD. Health at a Glance 2019; Organisation for Economic Co-Operation and Development (OECD): Paris, France, 2019. [Google Scholar]
- Ozkececi, G.; Eroglu, S.; Onrat, E.; Avsar, A.; Berktur, S.; Solak, O. Are we aware of the importance of the cardiac rehabilitation? Anadolu Kardiyol. Dergisi/Anatol. J. Cardiol. 2014, 14, 396–398. [Google Scholar] [CrossRef]
- A Chatziefstratiou, A.; Giakoumidakis, K.; Brokalaki, H. Cardiac rehabilitation outcomes: Modifiable risk factors. Br. J. Nurs. 2013, 22, 200–207. [Google Scholar] [CrossRef]
- Taylor, G.H.; Wilson, S.L.; Sharp, J. Medical, Psychological, and Sociodemographic Factors Associated With Adherence to Cardiac Rehabilitation Programs. J. Cardiovasc. Nurs. 2011, 26, 202–209. [Google Scholar] [CrossRef]
- Dalal, H.M.; Wingham, J.; Palmer, J.; Taylor, R.; Petre, C.; Lewin, R. Why do so few patients with heart failure participate in cardiac rehabilitation? A cross-sectional survey from England, Wales and Northern Ireland. BMJ Open 2012, 2, e000787. [Google Scholar] [CrossRef] [Green Version]
- Ali, M.; Qadir, F.; Javed, S.; Khan, Z.N.; Asad, S.; Hanif, B. Factors affecting outpatient cardiac rehabilitation attendance after acute myocardial infarction and coronary revascularization—A local experience. J. Pak Med. Assoc. 2012, 62, 347–351. [Google Scholar] [PubMed]
- McDonall, J.; Botti, M.; Redley, B.; Wood, B. Patient Participation in a Cardiac Rehabilitation Program. J. Cardiopulm. Rehabil. Prev. 2013, 33, 185–188. [Google Scholar] [CrossRef] [PubMed]
- Van Engen-Verheul, M.; De Vries, H.; Kemps, H.; Kraaijenhagen, R.; De Keizer, N.; Peek, N. Cardiac rehabilitation uptake and its determinants in the Netherlands. Eur. J. Prev. Cardiol. 2012, 20, 349–356. [Google Scholar] [CrossRef]
- Endo, N.; Goto, A.; Suzuki, T.; Matsuda, S.; Yasumura, S. Factors Associated With Enrollment and Adherence in Outpatient Cardiac Rehabilitation in Japan. J. Cardiopulm. Rehabil. Prev. 2015, 35, 186–192. [Google Scholar] [CrossRef] [Green Version]
- Hutchinson, P.; Meyer, A.; Marshall, B. Factors Influecing Outpatient Cardiac Rehabilitation Attendance. Rehabil. Nurs. 2015, 40, 360–367. [Google Scholar] [CrossRef]
- Park, L.G.; Schopfer, D.W.; Zhang, N.; Shen, H.; Whooley, M.A. Participation in Cardiac Rehabilitation among Patients with Heart Failure. J. Cardiac Fail. 2017, 23, 427–431. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Banerjee, A.T.; Grace, S.L.; Thomas, S.G.; Faulkner, G. Cultural factors facilitating cardiac rehabilitation participation among Canadian South Asians: A qualitative study. Heart Lung 2010, 39, 494–503. [Google Scholar] [CrossRef]
- De Vos, C.; Li, X.; Van Vlaenderen, I.; Saka, O.; Dendale, P.; Eyssen, M.; Paulus, D. Participating or not in a cardiac rehabilitation programme: Factors influencing a patient’s decision. Eur. J. Prev. Cardiol. 2012, 20, 341–348. [Google Scholar] [CrossRef]
- Shanmugasegaram, S.; Oh, P.; Reid, R.D.; McCumber, T.; Grace, S.L. A Comparison of Barriers to Use of Home- Versus Site-Based Cardiac Rehabilitation. J. Cardiopulm. Rehabil. Prev. 2013, 33, 297–302. [Google Scholar] [CrossRef] [PubMed]
- O’Connell, S. Barriers to attending cardiac rehabilitation. Nurs. Times 2014, 110, 15–17. [Google Scholar]
- Ghisi, G.L.D.M.; Dos Santos, R.Z.; Aranha, E.E.; Nunes, A.D.; Oh, P.; Benetti, M.; Grace, S.L. Perceptions of barriers to cardiac rehabilitation use in Brazil. Vasc. Health Risk Manag. 2013, 9, 485–491. [Google Scholar] [CrossRef] [Green Version]
- Graversen, C.B.; Eichhorst, R.; Ravn, L.; Christiansen, S.S.R.; Johansen, M.B.; Larsen, M.L. Social inequality and barriers to cardiac rehabilitation in the rehab-North register. Scand. Cardiovasc. J. 2017, 51, 316–322. [Google Scholar] [CrossRef]
- Foster, E.J.; Munoz, S.-A.; Crabtree, D.; Leslie, S.J.; Gorely, T. Barriers and facilitators to participating in cardiac rehabilitation and physical activity in a remote and rural population; a cross-sectional survey. Cardiol. J. 2019. [Google Scholar] [CrossRef] [Green Version]
- Bakhshayeh, S.; Sarbaz, M.; Kimiafar, K.; Vakilian, F.; Eslami, S. Barriers to participation in center-based cardiac rehabilitation programs and patients’ attitude toward home-based cardiac rehabilitation programs. Physiother. Theory Pract. 2019, 1–11. [Google Scholar] [CrossRef] [PubMed]
- Im, H.W.; Baek, S.; Jee, S.; Ahn, J.-M.; Park, M.W.; Kim, W.-S. Barriers to Outpatient Hospital-Based Cardiac Rehabilitation in Korean Patients With Acute Coronary Syndrome. Ann. Rehabil. Med. 2018, 42, 154–165. [Google Scholar] [CrossRef] [Green Version]
- Marzolini, S.; Fong, K.; Jagroop, D.; Neirinckx, J.; Liu, J.; Reyes, R.; Grace, S.L.; Oh, P.; Colella, T.J.F. Eligibility, Enrollment, and Completion of Exercise-Based Cardiac Rehabilitation Following Stroke Rehabilitation: What Are the Barriers? Phys. Ther. 2019, 100, 44–56. [Google Scholar] [CrossRef] [PubMed]
- Shanmugasegaram, S.; Oh, P.; Reid, R.D.; McCumber, T.; Grace, S.L. Cardiac rehabilitation barriers by rurality and socioeconomic status: A cross-sectional study. Int. J. Equity Health 2013, 12, 72. [Google Scholar] [CrossRef] [Green Version]
- Galati, A.; Piccoli, M.; Tourkmani, N.; Sgorbini, L.; Rossetti, A.; Cugusi, L.; Bellotto, F.; Mercuro, G.; Abreu, A.; D’Ascenzi, F. Cardiac rehabiltation barriers. Working Group on Cardiac Rein women: State of the art and strategies to overcome the current habilitation of the Italian Society of Cardiology. J. Cardiovasc. Med. 2018, 19, 689–697. [Google Scholar] [CrossRef]
- Pulignano, G.; Tinti, M.D.; Del Sindaco, D.; Tolone, S.; Minardi, G.; Lax, A.; Uguccioni, M. Barriers to cardiac rehabilitation access of older heart failure patients and strategies for better implementation. Monaldi Arch. Chest Dis. 2016, 84. [Google Scholar] [CrossRef]
- De Feo, S.; Tramarin, R.; Ambrosetti, M.; Riccio, C.; Temporelli, P.L.; Favretto, G.; Furgi, G.; Griffo, R. Gender differences in cardiac rehabilitation programs from the Italian survey on cardiac rehabilitation (ISYDE-2008). Int. J. Cardiol. 2012, 160, 133–139. [Google Scholar] [CrossRef] [PubMed]
- Supervía, M.; Medina-Inojosa, J.R.; Yeung, C.; Lopez-Jimenez, F.; Squires, R.W.; Pérez-Terzic, C.M.; Brewer, L.C.; Leth, S.E.; Thomas, R.J. Cardiac Rehabilitation for Women: A Systematic Review of Barriers and Solutions. Mayo Clin. Proc. 2017, 92, 565–577. [Google Scholar] [CrossRef] [Green Version]
- Clark, R.A.; Coffee, N.; Turner, D.; A Eckert, K.; Van Gaans, D.; Wilkinson, D.; Stewart, S.; Tonkin, A.M. Access to cardiac rehabilitation does not equate to attendance. Eur. J. Cardiovasc. Nurs. 2013, 13, 235–242. [Google Scholar] [CrossRef]
- Menezes, A.R.; Lavie, C.J.; Milani, R.V.; Forman, D.E.; King, M.; Williams, M.A. Cardiac rehabilitation in the United States Progress. Cardiovasc. Dis. 2014, 56, 522–529. [Google Scholar] [CrossRef]
- Sola, M.; Thompson, A.D.; Coe, A.B.; Marshall, V.D.; Thomas, M.P.; Prescott, H.C.; Konerman, M.C. Utilization of Cardiac Rehabilitation Among Cardiac Intensive Care Unit Survivors. Am. J. Cardiol. 2019, 124, 1478–1483. [Google Scholar] [CrossRef] [PubMed]
- Chaves, G.; Turk-Adawi, K.; Supervia, M.; Pio, C.S.D.A.; Abu-Jeish, A.-H.; Mamataz, T.; Tarima, S.; Jimenez, F.L.; Grace, S.L. Cardiac Rehabilitation Dose Around the World. Circ. Cardiovasc. Qual. Outcomes 2020, 13, e005453. [Google Scholar] [CrossRef]
- I Turkadawi, K.; Sarrafzadegan, N.; Grace, S.L. Global availability of cardiac rehabilitation. Nat. Rev. Cardiol. 2014, 11, 586–596. [Google Scholar] [CrossRef] [Green Version]
- Leung, Y.W.; Brual, J.; MacPherson, A.; Grace, S.L. Geographic issues in cardiac rehabilitation utilization: A narrative review. Health Place 2010, 16, 1196–1205. [Google Scholar] [CrossRef] [Green Version]
- Rój, J. Inequality in the Distribution of Healthcare Human Resources in Poland. Sustainability 2020, 12, 2043. [Google Scholar] [CrossRef] [Green Version]
- Peters, D.H.; Garg, A.; Bloom, G.; Walker, D.G.; Brieger, W.R.; Rahman, M.H. Poverty and Access to Health Care in Developing Countries. Ann. N. Y. Acad. Sci. 2008, 1136, 161–171. [Google Scholar] [CrossRef]
- Neutens, T. Accessibility, equity and health care: Review and research directions for transport geographers. J. Transp. Geogr. 2015, 43, 14–27. [Google Scholar] [CrossRef]
- Bem, A.; Ucieklak-Jeż, P.; Siedlecki, R. The Spatial Differentiation of the Availability of Health Care in Polish Regions. Procedia Soc. Behav. Sci. 2016, 220, 12–20. [Google Scholar] [CrossRef] [Green Version]
- Fransen, K.; Netens, T.; De Maeyer, P.; Deruyter, G. A commuter-based two-step floating catchment area method fo measuring spatial accesibility of daycare centers. Health Place 2015, 32, 65–73. [Google Scholar] [CrossRef]
- Sowada, C.; Sagan, A.; Kowalska-Bobko, I. Health System Review WHO: Geneva, Switzerland; Regional Office for Europe: Copenhagen, Denmark, 2019. [Google Scholar]
- Ucieklak-Jeż, P.; Bem, A.; Prędkiewicz, P. Relationships between Health Care Services and Health System Outcomes-Empirical Study on Health System Efficiency. In Proceedings of the European Financial Systems 2015 12th International Scientific Conference, Brno, Czech Republic, 18–19 June 2015; Kajurová, V., Krajíček, J., Eds.; Masarykova univerzita: Brno, Czech Republic, 2015; pp. 633–640. [Google Scholar]
- Rój, J.; Jankowiak, M. Assessment of Equity in Access to Percutaneous Coronary Intervention (PCI) Centres in Poland. Healthcare 2020, 8, 71. [Google Scholar] [CrossRef] [Green Version]
- Behfar, A.; Terzic, A.; Perez-Terzic, C.M. Regenerative Principles Enrich Cardiac Rehabilitation Practice. Am. J. Phys. Med. Rehabil. 2014, 93, S169–S175. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Piotrowicz, R. Rehabilitacja kardiologiczna w Narodowym Programie Profilaktyki i Leczenia Chorób Układu Sercowo-Naczyniowego POLKARD—Smutny stan rzeczy [Cardiological rehabilitation in Polish National Program for Prevention and Therapy of Cardiovascular Diseases POLKARD—The unfortunate state of things]. Kardiol. Pol. 2006, 64, 1158–1160. [Google Scholar]
- Jankowski, P.; Niewada, M.; Bochenek, A.; Bochenek-Klimczyk, K.; Bogucki, M.; Drygas, W.; Dudek, D.; Eysymontt, Z.; Grajek, S.; Kozierkiewicz, A.; et al. Optimal Model of Comprehensive Rehabilitation and Secondary Prevention. Kardiol. Pol. 2013, 71, 995–1003. [Google Scholar] [CrossRef] [Green Version]
- Kosycarz, E. Rehabilitation in the Polish health system and its financing methods. Finanse 2018. [Google Scholar] [CrossRef]
- Milewski, K.; Małecki, A.; Orszulik-Baron, D.; Kachel, M.; Hirnle, P.; Orczyk, M.; Dunal, R.; Mikołajowski, G.; Janas, A.; Nowak, Z.; et al. The use of modern telemedicine technologies in an innovative optimal cardiac rehabilitation program for patients after myocardial revascularization: Concept and design of RESTORE, a randomized clinical trial. Cardiol. J. 2019, 26, 594–603. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Database of Polish National Health Fund 2019. Available online: https://zip.nfz.gov.pl/GSL/GSL/Szpitale (accessed on 8 December 2019).
- Database of Polish National Health Fund 2019. Available online: https://statystyki.nfz.gov.pl (accessed on 29 December 2019).
- Karmowska, G. Badanie i pomiar rozwoju regionalnego na przykładzie województwa zachodniopomorskiego. Rocznik Nauk Rolniczych Seria G 2011, 98, 85–93. [Google Scholar]
- Ucieklak-Jeż, P.; Bem, A.; Siedlecki, R. Availability of Healthcare Services in Rural Areas: The Analysis of Spatial Differentiation. In Proceedings of the Advances in Analytics and Applications; Springer Science and Business Media LLC.: Berlin, Germany, 2016; pp. 313–322. [Google Scholar]
- Malkowski, A. Wielowymiarowa analiza przestrzennego zróżnicowania rozwoju społeczno-gospodarczego województw w latach 1999–2004. Folia Univ. Agric. Stetin. Oecon. 2007, 256, 205–212. [Google Scholar]
- Piepoli, M.F.; Hoes, A.W.; Agewall, S.; Albus, C.; Brotons, C.; Catapano, A.L.; Cooney, M.T.; Corrà, U.; Cosyns, B.; Deaton, C.; et al. 2016 European Guidelines on cardiovascular disease prevention in clinical practice. Revista Española de Cardiología 2016, 69, 939. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Wierzchowiecki, M.; Poprawski, K.; Nowicka, A.; Kandziora, M.; Piątkowska, A.; Jankowiak, M.; Michałowicz, B.; Stawski, W.; Dziamska, M.; Kaszuba, D.; et al. A new programme of multidisciplinary care for patients with heart failure in Poznań: One-year follow-up. Kardiol. Pol. 2006, 64, 1063–1070. [Google Scholar] [PubMed]
- Jankowiak, M. Ocena z użyciem cechy syntetycznej stopnia międzypaństwowej konwergencji systemów ochrony zdrowia w Unii Europejskiej. In System Ochrony Zdrowia: Problemy i Możliwości Ich Rozwiązań; Nojszewska, E., Ed.; Wolters Kluwer: Warszawa, Poland, 2011; pp. 324–336. [Google Scholar]
- Ucieklak-Jeż, P.; Bem, A. Availability of health care in rural areas in Poland. Probl. Small Agric. Holdings/Probl. Drobnych Gospod. Rolnych 2018, 4, 117–131. [Google Scholar] [CrossRef]
- Jankowiak, M. Convergence of Health Care Systems in European Union Countries in The Light of Quantitative Statistical Evaluations. In MBA Poznań-Atlanta, Working Papers in Management, Finance and Economics; MBA Poznań-Atlanta Uniwersytet Ekonomiczny: Poznań, Poland, 2010; pp. 1–20. [Google Scholar]
District (Voivodeship) | Population (2018) a | Number of Inpatient Rehab. Centr. b | Number of Outpatient Rehab. Centr. b | Total Number of Rehab. Centr. | Number of ACS c |
---|---|---|---|---|---|
Lower Silesian | 2,901,225 | 9 | 6 | 15 | 6811 |
Kuyavian-Pomeranian | 2,077,775 | 5 | 8 | 13 | 5830 |
Lubelskie | 2,117,619 | 7 | 7 | 14 | 5010 |
Lubuskie | 1,014,548 | 2 | 2 | 4 | 3489 |
Łódzkie | 2,466,322 | 4 | 7 | 11 | 6831 |
Lesser Poland | 3,400,577 | 3 | 12 | 15 | 6429 |
Masovian | 5,403,412 | 12 | 9 | 21 | 11,120 |
Opolskie | 986,506 | 2 | 1 | 3 | 2131 |
Podkarpackie | 2,129,015 | 3 | 7 | 10 | 4830 |
Podlaskie | 1,181,533 | 4 | 2 | 6 | 2111 |
Pomeranian | 2,333,523 | 11 | 4 | 15 | 5013 |
Silesian | 4,533,565 | 8 | 14 | 22 | 11,889 |
Świętokrzyskie | 1,241,546 | 2 | 5 | 7 | 3329 |
Warmian-Masurian | 1,428,983 | 4 | 1 | 5 | 3403 |
Greater Poland | 3,493,969 | 4 | 4 | 8 | 8232 |
West Pomeranian | 1,701,030 | 4 | 3 | 7 | 3419 |
Total-Poland | 38,411,148 | 84 | 92 | 176 | 89,877 |
k | District (Voivodeship) | Number of Inpatient Rehab. Cent. Per 100,000 Population X1 | Number of Outpatient Rehab. Cent. Per 100,000 Population X2 | Number of ACS Per 100,000 Population X3 |
---|---|---|---|---|
1 | Lower Silesian | 0.31 | 0.21 | 234.76 |
2 | Kuyavian-Pomeranian | 0.24 | 0.39 | 280.59 |
3 | Lubelskie | 0.33 | 0.33 | 236.59 |
4 | Lubuskie | 0.20 | 0.20 | 343.90 |
5 | Łódzkie | 0.16 | 0.28 | 276.97 |
6 | Lesser Poland | 0.09 | 0.35 | 189.06 |
7 | Masovian | 0.22 | 0.17 | 205.80 |
8 | Opolskie | 0.20 | 0.10 | 216.01 |
9 | Podkarpackie | 0.14 | 0.33 | 226.87 |
10 | Podlaskie | 0.34 | 0.17 | 178.67 |
11 | Pomeranian | 0.47 | 0.17 | 214.83 |
12 | Silesian | 0.18 | 0.31 | 262.24 |
13 | Świętokrzyskie | 0.16 | 0.40 | 268.13 |
14 | Warmian-Masurian | 0.28 | 0.07 | 238.14 |
15 | Greater Poland | 0.11 | 0.11 | 235.61 |
16 | West Pomeranian | 0.24 | 0.18 | 201.00 |
Mean value | 0.23 | 0.24 | 238.07 | |
Standard deviation | 0.10 | 0.10 | 39.94 | |
Class of variable | stimulant | stimulant | de-stimulant |
k | District (Voivodeship) | Normalized Value of Inpatient Rehab. Centers Z1 | Normalized Value of Outpatient Rehab. Centers Z2 | Normalized Value of ACS Z3 |
---|---|---|---|---|
1 | Lower Silesian | 0.849 | −0.278 | 0.083 |
2 | Kuyavian-Pomeranian | 0.117 | 1.458 | −1.064 |
3 | Lubelskie | 1.063 | 0.927 | 0.037 |
4 | Lubuskie | −0.340 | −0.373 | −2.649 |
5 | Łódzkie | −0.708 | 0.472 | −0.974 |
6 | Lesser Poland | −1.485 | 1.145 | 1.227 |
7 | Masovian | −0.078 | −0.670 | 0.808 |
8 | Opolskie | −0.281 | −1.305 | 0.552 |
9 | Podkarpackie | −0.931 | 0.910 | 0.281 |
10 | Podlaskie | 1.147 | −0.644 | 1.487 |
11 | Pomeranian | 2.544 | −0.623 | 0.582 |
12 | Silesian | −0.558 | 0.715 | −0.605 |
13 | Świętokrzyskie | −0.719 | 1.630 | −0.753 |
14 | Warmian-Masurian | 0.530 | −1.611 | −0.002 |
15 | Greater Poland | −1.209 | −1.178 | 0.062 |
16 | West Pomeranian | 0.060 | −0.575 | 0.928 |
District (Voivodeship) | WA Indicator | Class of WA | WB Indicator | Class of WB |
---|---|---|---|---|
Lower Silesian | 0.285 | average | 0.218 | average |
Kuyavian-Pomeranian | 0.788 | above average | 0.170 | average |
Lubelskie | 0.995 | above average | 0.676 | above average |
Lubuskie | −0.356 | average | −1.121 | below average |
Łódzkie | −0.118 | average | −0.403 | average |
Lesser Poland | −0.170 | average | 0.295 | average |
Masovian | −0.374 | average | 0.020 | average |
Opolskie | −0.793 | below average | −0.345 | average |
Podkarpackie | −0.011 | average | 0.086 | average |
Podlaskie | 0.251 | average | 0.663 | above average |
Pomeranian | 0.960 | above average | 0.834 | above average |
Silesian | 0.079 | average | −0.149 | average |
Świętokrzyskie | 0.455 | average | 0.053 | average |
Warmian-Masurian | −0.540 | average | −0.361 | average |
Greater Poland | −1.193 | below average | −0.775 | below average |
West Pomeranian | −0.258 | average | 0.138 | average |
Standard deviation | 0.592 | 0.505 | ||
Classification of WA/WB indicators value | >0.592 ≥−0.592; ≤0.592 <−0.592 | above average average below average | >0.505 ≥−0.505; ≤0.505 <−0.505 | above average average below average |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
Jankowiak, M.; Rój, J. Regional Variability in the Access to Cardiac Rehabilitation in Poland. Healthcare 2020, 8, 468. https://doi.org/10.3390/healthcare8040468
Jankowiak M, Rój J. Regional Variability in the Access to Cardiac Rehabilitation in Poland. Healthcare. 2020; 8(4):468. https://doi.org/10.3390/healthcare8040468
Chicago/Turabian StyleJankowiak, Maciej, and Justyna Rój. 2020. "Regional Variability in the Access to Cardiac Rehabilitation in Poland" Healthcare 8, no. 4: 468. https://doi.org/10.3390/healthcare8040468