New cardiac hospitals often trigger sharp increases in the utilization of invasive and costly heart procedures to open up clogged arteries, including bypass surgeries and angioplasties, according to a study in March 7 issue of the Journal of the American Medical Association. The researchers, led by a University of Michigan team, found that the rate of these procedures rises faster in areas where a specialty cardiac hospital opens compared with areas where general hospitals deliver heart care. Nonemergency angioplasties rise the fastest among the Medicare beneficiaries who were included in the study, researchers found.
This is the first study to show that specialty cardiac hospitals increased the use of these procedures in the hospital markets where they opened, compared with regions where existing hospitals added heart-care services or regions where there was no change in heart-care services, said lead author Brahmajee Nallamothu, a physician who is an assistant professor of cardiovascular medicine at the University of Michigan Medical School.
The study, which used Medicare data from 1995 to 2003, identified 13 hospital referral regions where 14 specialty cardiac hospitals opened during that time period, offering bypass surgery or percutaneous coronary intervention, which includes angioplasty, stenting and related procedures. Researchers then calculated population-based rates for each year across the nation. While the number of these procedures rose in many general hospitals, the increase was far more dramatic in the hospital referral regions where a specialty cardiac facility opened, the study found, rising by more than twice as much as the rates in those regions where no specialty hospital had opened. -- by Michael Romano