Open Access Open Badges Research article

How do hospital administrators perceive cardiac rehabilitation in a publicly-funded health care system?

Sherry L Grace1256*, Sabrina Scarcello1, Janet Newton2, Blair O’Neill3, Kori Kingsbury4, Tiziana Rivera5 and Caroline Chessex26

Author affiliations

1 Department of Kinesiology and Health Science, Bethune 368, York University, 4700 Keele St, Toronto, ON, M3J 1P3, Canada

2 Peter Munk Cardiac Center Cardiovascular Rehabilitation & Prevention Program, Toronto General Hospital, University Health Network, 200 Elizabeth St, Toronto, ON, M5G 2C4, Canada

3 Division of Cardiology, Mazankowski Alberta Heart Institute, University of Alberta, 8440 112 St. NW, Edmonton, AB, T6G 2B7, Canada

4 Cardiac Care Network of Ontario, 4100 Yonge St., Suite 502, Toronto, ON, M2P 2B5, Canada

5 MacKenzie Health, 10 Trench St, Richmond Hill, ON, L4C 4Z3, Canada

6 Faculty of Medicine, University of Toronto, 1 King’s College Circle, Toronto, ON, M5S 1A8, Canada

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Citation and License

BMC Health Services Research 2013, 13:120  doi:10.1186/1472-6963-13-120

Published: 28 March 2013



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.


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.


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%).


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.

Hospital administrators; Attitude of health personnel; Outpatient health services; Rehabilitation centers; Cardiac care facilities