When Margaret Chen walked out of the hospital after her heart attack last year, she faced a daunting question: what now? Like thousands of Australians, she was sent home without a clear roadmap — and without a referral to the very program that could save her life.
New research from Monash University has brought this invisible gap into sharp focus. A study跟踪了超过7,100名维多利亚州的心脏病患者,across 13 public hospitals between 2019 and 2021, found that patients who attended cardiac rehabilitation were four times less likely to die from another cardiac event compared to those who didn't. Yet only one in five Victorian cardiac patients — roughly 20 percent — actually accessed these programs.
The numbers are stark: nearly 400,000 Australians fail to attend cardiac rehabilitation each year after a heart attack or similar event, despite overwhelming evidence of its benefits. Led by Dr. Susie Cartledge and published in the International Journal of Cardiology, this is the first study in two decades to examine the complete cardiac patient journey in Victoria by linking the Vic Cardiac Outcomes Registry to outpatient care data.
"The reduced risk of dying from further cardiac events was directly related to the number of cardiac rehabilitation sessions attended," Dr. Cartledge said. "Mortality was four times higher in those who didn't attend any sessions compared to those who attended the full six-week program."
The six-to-eight-week programs combine supervised exercise, self-management education, and psychosocial support — a package that research shows reduces repeat heart attacks, lowers hospital readmissions, and improves long-term survival. At the 12-month mark, patients who attended were healthier, more functional, and far less likely to need emergency readmission.
So why aren't more people going? The study points to a critical bottleneck: referral. While 85 percent of patients who underwent a common heart procedure called PCI were referred to rehabilitation, only 19.3 percent of those actually showed up. "Lack of attendance is multifaceted but is driven by lack of referral, lack of patient's understanding about the importance of attending, and the fragmented systems between inpatient and outpatient care," Dr. Cartledge noted.
Unlike Austria, Canada, Denmark, the UK, and the United States, Australia currently lacks a national cardiac rehabilitation registry — meaning the patient's journey from hospital bed to recovery program often falls through the cracks.
But health advocates see reason for optimism. The data already exists; the problem is that systems aren't talking to each other. Fixing referral pathways and raising awareness among both doctors and patients could be enough to close the gap — and save thousands of lives in the process. The evidence is clear. The question now is whether Australia will act on it.