According to national Swedish guidelines cardiovascular prevention and rehabilitation should be available for all coronary patients. Yet, over the years the access to this service has varied considerably between Swedish hospitals. Over the past five years the National Heart- and Lung Patients' Association has been engaged in a major staff training and research effort within this field assisted by a medical expert group. In assuring the quality of these efforts hospitals have been audited using a grading system of one to five hearts: one heart meaning an unsatisfactory level, five hearts an optimal level of care. An evaluation has shown that the support and grading has contributed to an improvement of preventive and rehabilitation care, though the ultimate goal of "five hearts for all" still remains to be achieved.

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