Perceptions of barriers to and facilitators of cardiac rehabilitation in healthcare providers and policy stakeholders: a questionnaire survey

Abstract Background: In Korea, cardiac rehabilitation is poorly established in hospitals and communities. Therefore, this study aimed to determine the perceptions of the need for cardiac rehabilitation programs and relevant health policies among hospital directors and health policy managers.Methods: We sent a questionnaire to 592 public health policy managers and directors of selected hospitals, 132 of whom returned a completed questionnaire (response rate: 22.3 %). The participants were categorized into five types of organizations depending on their practice of PCI(Percutaneous Coronary Intervention), establishment of cardiac rehabilitation, director of hospital, and civil servant. The responses were analyzed using a Kruskal-Wallis test. Differences in the opinions between directors of hospitals that perform/do not perform PCI, directors of hospitals with/without cardiac rehabilitation, and between hospital directors and health policy managers were analyzed with Mann-Whitney tests for post-hoc comparisons. Results: Responses about targeting diseases for cardiac rehabilitation, patients’ roles in cardiac rehabilitation, hospitals’ roles in cardiac rehabilitation, and governmental health policies’ roles in cardiac rehabilitation were more positive among hospitals that perform PCI than those that do not. Responses to questions about the effectiveness of cardiac rehabilitation and hospitals’ roles in cardiac rehabilitation tended to be more positive in hospitals with cardiac rehabilitation than in those without. Hospital directors responded more positively to questions about targeting diseases for cardiac rehabilitation and governmental health policies’ roles in cardiac rehabilitation than civil servants, and both hospitals and public organizations provided negative responses to the question about patients’ roles in cardiac rehabilitation. Responses to questions about targeting diseases for cardiac rehabilitation, patients’ roles in cardiac rehabilitation, and governmental health policies’ roles in cardiac rehabilitation were more positive in hospitals that perform PCI than those that do not and public organizations.Conclusions: Hospitals must ensure timely referral, provide education, and promote the need for cardiac rehabilitation. In addition, governmental socioeconomic support is needed for incentives, nighttime cardiac rehabilitation programs, and continuum of service into community-based programs.