Pulse ·
Australia's cardiac rehab problem: real reform, long way to go
Around 500,000 Australians are hospitalised with a heart condition each year. Survivors face ten times the risk of future cardiac events — yet cardiac rehabilitation, associated with reduced readmission and mortality, remains underutilised, underfunded, and unevenly distributed.
The SOLVE-CHD initiative — a five-year NHMRC Synergy Grant from the University of Sydney — is building a national network across 50+ institutions to close the evidence-to-access gap through data, telehealth, and Indigenous-appropriate care. Women and First Nations peoples are disproportionately under-served.
What just happened
A piece published in InSight+, the online platform of the Medical Journal of Australia, in June 2026, asks a question the system has been avoiding: if cardiac rehabilitation demonstrably reduces readmission and mortality after a cardiac event — why is barely a fraction of the people who need it actually receiving it?
The answer, as the analysis makes clear, is not a mystery. Cardiac rehabilitation in Australia is underutilised, underfunded, and unevenly distributed. Programmes exist. Referral pathways exist. Evidence exists. What does not yet consistently exist is the translation of that evidence into the consultation room — and from there, into the lived experience of the person who just survived a heart attack and is trying to understand what comes next.
The numbers from the Australian Institute of Health and Welfare are not abstract: around 500,000 Australians are admitted to hospital with a heart condition each year. Survivors face ten times the risk of a future cardiac event. Forty per cent are readmitted within three years. Twenty per cent die within three years. Cardiac rehabilitation — supervised exercise training, cardiovascular risk factor education, psychological support, and medication review — has a robust and consistent evidence base for improving outcomes across each of those dimensions.
The gap between that evidence and what patients actually receive is the problem the SOLVE-CHD initiative was built to close: a five-year National Health and Medical Research Council Synergy Grant that has assembled over 140 clinicians, researchers, and consumers from more than 50 institutions across Australia to build systems that actually work at scale.
The both-and
Cardiac rehabilitation works. The system for delivering it does not work well enough. Both are true — and naming both, precisely, matters.
The InSight+ analysis is not reporting a new discovery. Under-referral and underutilisation of cardiac rehabilitation has been a documented concern in Australian clinical literature for many years. What is new is the scale of the reform infrastructure now assembling around it. SOLVE-CHD’s four workstreams — real-time national data and quality benchmarking, novel technology-enabled interventions, a national network to share implementation knowledge, and a World Heart Federation Roadmap — represent a more structured attempt at system-level change than has existed before.
The equity dimension of the access gap is the part that rarely receives proportionate attention. Women who experience acute coronary syndromes are less likely to receive secondary prevention medications and are more likely to experience longer delays in symptom recognition and treatment. That is not a finding from a subanalysis — it is a consistent pattern across AIHW data and international literature. Cardiac rehabilitation attendance rates in women are consistently lower than in men, and the reasons are structural: programme timing, transport barriers, domestic responsibilities, and — at the clinical referral level — documented bias in who gets offered the programme at discharge.
For Aboriginal and Torres Strait Islander peoples, coronary events occur at twice the rate of non-Indigenous Australians, often at younger ages. The cultural safety and geographic reach of cardiac rehabilitation programmes has historically not matched the communities where burden is highest. The Heart Foundation’s cardiac services directory maps available programmes — but a map is not access. It is the beginning of the question.
Telehealth is part of SOLVE-CHD’s answer. The pandemic-era rapid expansion of telehealth cardiac rehabilitation demonstrated that home-based models are feasible, and in some populations — particularly those with transport barriers — more effective at achieving programme completion than clinic-based models. Whether that evidence is now embedded in referral and programme design, rather than existing as a pandemic-era improvisation that faded, is what the next five years of the SOLVE-CHD initiative will determine.
2 cents
If you have had a cardiac event — heart attack, bypass surgery, coronary stent, heart failure diagnosis — and you have not been enrolled in a cardiac rehabilitation programme, it is worth asking your cardiologist or GP specifically: “Am I eligible for cardiac rehab, and was a referral sent?”
That question needs to be explicit, because under-referral is a documented pattern. A cardiac rehabilitation programme provides more than supervised exercise. It includes systematic cardiovascular risk factor review, medication reconciliation, education about warning signs, and psychological support during a period when anxiety and depression are clinically common after a cardiac event.
The Heart Foundation’s directory lists programmes by location. Telehealth options exist for those who cannot attend in person.
This is general information. Your post-cardiac-event clinical pathway depends on your presentation, comorbidities, and treating team — that conversation belongs with your cardiologist and GP.
Verdict
Verdict: maybe — watch this.
The case for cardiac rehabilitation is not in question — the evidence base is robust and consistent. The verdict here is on the reform trajectory. SOLVE-CHD is real, its infrastructure is assembling, and the June 2026 InSight+ analysis represents serious clinical attention to a system-level gap that has persisted for decades. But the system has been aware of this gap for years without it closing materially. Whether the NHMRC investment, the national network, and the telehealth models produce measurable change in referral and completion rates — particularly for women and First Nations peoples — within the five-year window is genuinely uncertain. This is the reform to watch, and the question to bring into the consulting room now.