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Growth of cardiac services linked to competition, not improved patient care, study finds
Date:7/10/2013

ge of the U.S. population with timely access to heart catheterization services increased by just 1.8 percent. Researchers estimate the 251 new cardiac catheterization programs created during the study period cost $2 billion to $4 billion.

In general, researchers found the new cardiac catheterization programs targeted neighborhoods already served by other programs, where competition for patients was already high and where timely access for patients did not improve.

There were some exceptions to the findings. Access to cardiac catheterization programs in Mississippi grew sharply during the study period and in Missouri the growth in programs led to a meaningful drop in projected transport times for patients, according to the study.

Although the pace of new cardiac catheterization programs slowed during the study period, expansions continue at a fast pace. Researchers say policymakers should consider three approaches that could be used to improve access to cardiac catheterization services while restraining duplication of services.

The options include voluntary systems where hospitals and emergency medical providers work to provide services to more people while avoiding duplication. The largest example of such a system is the North Carolina Regional Approach to Cardiovascular Emergencies, or RACE protocol.

Another approach is to use market-based solutions to discourage duplication of cardiac catheterization programs. This could include reducing payment for the service, which could discourage new investments.

The final approach is state review and approval of plans to establish cardiac catheterization labs or similar technology. Twenty-seven states already use the approach, and the study found that hospitals in states with a robust oversight program were 40 percent less likely to introduce a new catheterization program in any given year.


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Contact: Warren Robak
robak@rand.org
310-451-6913
RAND Corporation
Source:Eurekalert

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