title: How do hospital administrators perceive cardiac rehabilitation in a publicly-funded health care system?
abstract: BACKGROUND
  Patient and provider-related factors affecting access to cardiac rehabilitation (CR) have been extensively studied, but health-system administration factors have not. The objectives of this study were to investigate hospital administrators' (HA) awareness and knowledge of cardiac rehabilitation (CR), perceptions regarding resources for and benefit of CR, and attitudes toward and implementation of inpatient transition planning for outpatient CR.
  
  
  METHODS
  A cross-sectional and observational design was used. A survey was administered to 679 HAs through Canadian and Ontario databases. A descriptive examination was performed, and differences in HAs' perceptions by role, institution type and presence of within-institution CR were compared using t-tests.
  
  
  RESULTS
  195 (28.7%) Canadian HAs completed the survey. Respondents reported good knowledge of what CR entails (mean=3.42±1.15/5). Awareness of the closest site was lower among HAs working in community versus academic institutions (3.88±1.24 vs. 4.34±0.90/5 respectively; p=.01). HAs in non-executive roles (4.77±0.46/5) perceived greater CR importance for patients' care than executives (4.52±0.57; p=.001). HAs perceived CR programs should be situated in both hospitals and community settings (n=134, 71.7%).
  
  
  CONCLUSIONS
  HAs value CR as part of patients' care, and are supportive of greater CR provision. Those working in community settings and executives may not be as aware of, or less-likely to value, CR services. CR leaders from academic institutions might consider liaising with community hospitals to raise awareness of CR benefits, and advocate for it with the executives in their home institutions.
authors.affiliation: Department of Kinesiology and Health Science, Bethune 368, York University, 4700 Keele St, Toronto, ON M3J 1P3, Canada. sgrace@yorku.ca
authors.forename: Sherry L
authors.initials: SL
authors.lastname: Grace
authors.forename: Sabrina
authors.initials: S
authors.lastname: Scarcello
authors.forename: Janet
authors.initials: J
authors.lastname: Newton
authors.forename: Blair
authors.initials: B
authors.lastname: O'Neill
authors.forename: Kori
authors.initials: K
authors.lastname: Kingsbury
authors.forename: Tiziana
authors.initials: T
authors.lastname: Rivera
authors.forename: Caroline
authors.initials: C
authors.lastname: Chessex
mesh_terms: D002170:Canada; D000072038:Cardiac Rehabilitation; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000191:economics*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006740:Hospital Administrators / Q000523:psychology*; D006779:Hospitals, Public; D006801:Humans; D008297:Male; D009313:National Health Programs / Q000191:economics*
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