Navigation Links
Hospitals Vary Widely in Rate of Heart Procedures: Study
Date:8/8/2011

By Amanda Gardner
HealthDay Reporter

MONDAY, Aug. 8 (HealthDay News) -- At some U.S. hospitals, nearly everyone who has cardiac catheterization to diagnose heart disease is found to have major blockages requiring some kind of action.

But in other hospitals, relatively few are found to have a major blockage when undergoing this procedure, indicating that many patients may be getting unnecessary procedures, according to a study in the Aug. 16 issue of the Journal of the American College of Cardiology.

"We're not doing as well as we thought. We need to improve," said study author Dr. Pamela S. Douglas, the Ursula Geller professor of cardiovascular research at Duke Clinical Research Institute in Durham, N.C. "You don't want to do this in people who don't need it."

Cardiac catheterization is when a doctor threads a small tube called a catheter into the heart from the groin or the arm. Through images obtained from angiography, the doctor can see blockages that might signal problems ahead.

This study is a follow-up to a 2010 paper by the same group of researchers that found that "the rate at which obstructive coronary artery disease was found nationally was much lower than everybody expected," Douglas said.

The new study may be the first to look at how hospitals differ.

This time, Douglas and her colleagues reviewed data on almost 600,000 patients with no known heart disease who had elected to undergo coronary angiography from 2005 to 2008 at one of almost 700 hospitals nationwide.

Obstructive coronary artery disease (CAD) was defined as a 50 percent or higher blockage of a major vessel.

While some hospitals found major blockages in all patients undergoing the procedure, others only found blockages in 23 percent of patients. The rates stayed consistent at institutions over the three years.

It also seemed clear, though, why hospitals varied so much.

Those that found lower rates of obstructive CAD tended to perform the procedure on lower-risk patients, including those who were younger and had no or atypical symptoms.

Hospitals at the other end of the scale seemed to select their patients more carefully, only performing the procedure on higher-risk patients, such as those with hypertension or diabetes. They also were less likely to prescribe aspirin, beta blockers, blood thinners and statins, and more likely to be low-volume centers, meaning they perform fewer of these procedures.

"When we looked at the average rate of finding obstructive coronary artery disease, we found that all hospitals are not the same," Douglas said. "There is substantial variation."

"That would represent a pattern of care in that particular institution compared to another institution," she added. "It's not just a patient-by-patient decision but decisions determined by the practice or culture in a particular hospital, whether hospitals are more or less aggressive."

Douglas suggests that the guidelines for making decisions on who undergoes this procedure should be tightened.

"There's a need for consensus agreement amongst cardiologists, and some standards as to which kinds of patients should undergo catheterization and which shouldn't," she said.

The American College of Cardiology will issue such criteria later this year, she added.

Dr. John Gassler, a professor of medicine at the University of Rochester Medical Center in New York, finds the study "intriguing" but doesn't feel it answers the question of overuse of diagnostic catheterization.

"There are many factors involved in making this decision," he said.

More information

The U.S. National Library of Medicine has more on cardiac catheterization.

SOURCES: Pamela S. Douglas, M.D., Ursula Geller professor of cardiovascular research, Duke Clinical Research Institute, Durham, N.C.; John Gassler, M.D., associate professor, medicine, University of Rochester Medical Center, New York; Aug. 16, 2011, Journal of the American College of Cardiology


'/>"/>
Copyright©2010 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. The private sale of drugs in public hospitals
2. Most pandemic plans in Ontario hospitals have not been tested: Queens University study
3. SHARECOR Partners With Quantros, Inc. to Facilitate Core Measures and Regulatory Reporting in Louisiana Hospitals
4. Kaiser Foundation Health Plan and Hospitals Report Fourth Quarter and Fiscal Year 2009 Financial Results
5. Father Channels His Grief into Advocacy, Promotes Simple Actions to Make Hospitals Safer for Children
6. Vestara and EXP Pharmaceutical Services Corp. Announce Partnership Making Available Industry's Only Automated Pharmaceutical Waste Management Solution to over 5,000 U.S. Hospitals
7. Small to Mid-Sized Hospitals Turn to Orion Health to Implement Health IT Solutions for Improved Patient Care and Outcomes
8. Patients Do Better at Hospitals That Follow Stroke Guidelines
9. Evidence-based care and outcomes improve at Get With The Guidelines-Stroke hospitals
10. Global Hospitals and Healthcare Suppliers Focus on Cutting Costs and Improving Quality at 2010 GHX Supply Chain Summit
11. COBRAGuard Partners With THA to Offer Texas Hospitals COBRA Relief
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Hospitals Vary Widely in Rate of Heart Procedures: Study 
(Date:3/24/2017)... , ... March 24, 2017 , ... “Vintage and Harvest ... retired minister and college Bible teacher residing in North Carolina with his wife, Anna ... have blessed them with six grandchildren. David is also the author of “Shadow and ...
(Date:3/24/2017)... ... ... “The Adventures of Joey, The Dog Who Barks at Puddles”: a boisterous story ... fullest, as God intended. “The Adventures of Joey, The Dog Who Barks at Puddles” ... passion for writing, especially about truth and human behavior. , Published by Christian Faith ...
(Date:3/23/2017)... ... 23, 2017 , ... A recent report from the National Council on Teacher ... NCTQ report suggests, based on a review of GPA and SAT/ACT requirements at 221 ... the U.S. It argues that this higher bar should be set by states, by ...
(Date:3/23/2017)... ... March 23, 2017 , ... Demonstrating their commitment to ... public health departments have been awarded national accreditation through the Public Health ... the expanding network of communities across the nation whose health departments meet rigorous ...
(Date:3/23/2017)... ... March 23, 2017 , ... PAINWeekEnd (PWE) Oklahoma City, on ... Avenue, will be an educational and exciting program providing busy clinicians and allied ... chronic pain. , Oklahoma is in a healthcare crisis. The state ranks 46th ...
Breaking Medicine News(10 mins):
(Date:3/23/2017)... Mosaic Life Care, based in St. Joseph, Missouri , ... network of 58 clinics, located in 22 cities, and its flagship St. Joseph Medical ... improve the delivery of health care to its patients, including the insurance, billing and ... ... Mosaic Life Care St. Joseph Medical Center ...
(Date:3/23/2017)... 2017  Transportation Insight, a multi-modal lead logistics solutions ... management firm with expertise serving clients in the food ... Zaffarano was named a 2017 Food Logistics ... the only publication exclusively dedicated to covering the movement ... "Rick has brought to Transportation Insight a wealth ...
(Date:3/23/2017)... 23, 2017 As a result of ... the prevalence of allergic diseases, cutting edge developments ... revolutionising the ways in which pharmaceutical and biotech ... promises to be both a high quality meeting ... interest groups, immunologists, research scholars and doctors. The ...
Breaking Medicine Technology: