A new study published in Health Affairs (subscription required) has raised some questions regarding the rapid growth and distribution of cardiac surgery programs from 1993 to 2004 in the face of declining volumes, shedding light on little improvements in patient access - often the justification for creating such programs. As reported in today's Daily Briefing, an increase in cardiac surgery programs has duplicated services and increased competition in many areas while doing little to expand access to cardiac surgery services in poorly served regions.
Since 1997, the number of coronary artery bypass grafts (CABGs) performed in the United States has decreased. Nonetheless, from 1993 to 2004, the number of cardiac surgery programs continued to rise. In fiscal year 2004 they were the third most profitable surgical programs, accounting for 25% to 40% of a hospital's net revenue.
Adoption of Cardiac Surgery Programs Questioned in Light of Declining Volumes, Modest Access Improvements
A June editorial in the New England Journal of Medicine discusses the role of telemanagement in connecting primary care physicians and their patient cohorts in remote areas with specialists when care requires consultation. Highlighting results from the ECHO (Extension for Community Healthcare Outcomes) Program, which connected PCPs with specialists via videoconferencing, the author notes the positive outcomes of such a collaboration: the rate of sustained virologic response among hepatitis C patients being treated at the AMC was similar to that of those patients being treated by PCPs in remote consult with specialists.
Telemanagement as a Tool for PCP-Cardiologist Collaboration?
With ever more hospitals looking to consolidate cardiovascular services, a study released Wednesday by the Journal of the American Medical Association casts doubts on the efficacy of the consolidated approach for STEMI patients, due in large part to delays in patient transfer.
A Condemnation of Consolidation? STEMI Network Study Suggests Delays in Transfer are Damaging Outcomes