Long term experience with a novel interventional cardiology network model: Learned lessons

Ivan J. Nuñez Gil, Marian Bas, Antonio Fernández-Ortiz, Javier Escaned, Pablo Salinas, Luis Nombela-Franco, Pilar Jiménez-Quevedo, Nieves Gonzalo, María José Pérez Vizcayno, Carlos Macaya


Objective: Many studies have assessed ischemic heart disease due to its high prevalence, secondary morbidities, high death rate, economic and social impact. We propose a novel model of intervention, the central objective of which is to guarantee the equal opportunity, avoiding patient transport and improving the use of resources assigned to cardiac care, ensuring patient safety and efficiency.
Methods: We projected a model in which interventional cardiologists based at a high-volume center (Madrid, Hospital Clínico San Carlos [HCSC]) established an alliance with two other hospitals (Leganés, Hospital Severo Ochoa [HSO] and Alcalá, Hospital Príncipe de Asturias [Hospital Príncipe de Asturias ]), creating the opportunity to install a catheterization laboratory at each hospital (satellite units). We reviewed the clinical and economic long-term results, together with local hospital satisfaction levels.
Results: Between 2000 and 2014, 63,817 cardiac procedures: 54,516 at HCSC, 7,618 at HSO (since 2003) and 1,683 at HUPA (since 2012) were performed. Using a random sample obtained between 2011-2012 assessing 737 percutaneous coronary interventions (PCI) classified according to the patient’s residence. No significant differences in bleedings during the first year (3.2% vs. 1.2%; p = .29), readmissions for a new myocardial infarction (5.7% vs. 3.5%; p = .41) or any-cause mortality (0.7% vs. 0%, p = .418)were observed. Subsequent scoring by professionals revealed both a high degree of satisfaction with the model and significant cost-savings implementing this network.
Conclusions: A network on interventional cardiology is a sustainable experience in our environment, offering a high standard of patient-centered care quality, as required by health authorities and national and international scientific-societies. It reduced costs, and was perceived with an excellent degree of satisfaction by professionals and managers of the peripheral centers.

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DOI: https://doi.org/10.5430/jha.v5n4p87


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Journal of Hospital Administration

ISSN 1927-6990(Print)   ISSN 1927-7008(Online)

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