BackgroundIn 2006, the Canadian Cardiovascular Society (CCS) Access to Care Working Group recommended a 30-day wait time benchmark for cardiac rehabilitation (CR). The objectives of the current study were to: (1) describe cardiac patient perceptions of actual and ideal CR wait times, (2) describe and compare cardiac specialist and CR program perceptions of wait times, as well as whether the recommendations are appropriate and feasible, and (3) investigate actual wait times and factors that CR programs perceive to affect these wait times.MethodsPostal and online surveys to assess perceptions of CR wait times were administered to CR enrollees at intake into 1 of 8 programs, all CCS member cardiac specialists treating patients indicated for CR, and all CR programs listed in Canadian directories. Actual wait times were ascertained from the Canadian Cardiac Rehabilitation Registry. The design was cross-sectional. Responses were described and compared.ResultsResponses were received from 163 CR enrollees, 71 cardiac specialists (9.3% response rate), and 92 CR programs (61.7% response rate). Patients reported that their wait time from hospital discharge to CR initiation was 65.6 ± 88.4 days (median, 42 days), while their ideal median wait time was 28 days. Most patients (91.5%) considered their wait to be acceptable, but ideal wait times varied significantly by the type of cardiac indication for CR. There were significant differences between specialist and program perceptions of the appropriate number of days to wait by most indications, with CR programs perceiving shorter waits as appropriate (p < 0.05). CR programs reported that feasible wait times were significantly longer than what was appropriate for all indications (p < 0.05). They perceived that patient travel and staff capacity were the main factors negatively affecting waits. The median wait time from referral to program initiation was 64 days (mean, 80.0 ± 62.8 days), with no difference in wait by indication.ConclusionsWait times following access to cardiac rehabilitation are prolonged compared with consensus recommendations, and yet are generally acceptable to most patients. Wait times following percutaneous coronary intervention in particular may need to be shortened. Future research is required to provide an evidence base for wait time benchmarks.

Background: The Multistakeholder Framework of Rurality project was funded by Health Canada's Rural and Remote Health Innovations Initiative. The aim of this project was to develop a tool to assist rural communities with health human resource planning and to help governments and communities in recruiting and retaining health care providers in rural and remote communities. Methods: A national survey was sent to nurses, physicians, and pharmacists living in rural or remote communities to determine, among other factors, satisfaction with their personal and professional lives in those communities. One of the questions asked in the survey was “Do you plan to be in practice in the community in two years?” Results: Completed surveys were returned by 1019 pharmacists. Pharmacists who were married, had children living at home, were between the ages of 35 and 54 years, and had between 6 and 24 years in practice were more likely to say they would remain in the community. Communities where there were better working hours, better availability of coverage and backup, higher earning potential, and greater opportunities were more likely to retain pharmacists, as were communities where there were better opportunities for family members. Pharmacists were also more likely to state an intention to remain in communities where they had a sense of belonging and a sense of being appreciated. Multivariate predictors of pharmacists' intent to remain were children living at home, professional factors, and personal factors. Conclusions/Implications: Despite some study limitations, the results presented here could be used to help communities select pharmacists who are most likely to remain in practice in the communities for longer periods. Community attributes such as distance to large population centres cannot be changed, but attributes that contribute to personal and professional satisfaction could be altered.