 |
|
Regionalization of Care for Acute Coronary Syndromes
More Evidence Is Needed
Saif S. Rathore, MPH;
Andrew J. Epstein, PhD, MPP;
Kevin G. M. Volpp, MD, PhD;
Harlan M. Krumholz, MD
JAMA. 2005;293:1383-1387.
|
|
| Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings. |
|
|
|
There is a growing movement advocating the treatment of patients with acute coronary syndromes (ACS) at regional centers with dedicated facilities.1-2 Proponents contend that regionalized ACS care will save lives by improving access to new technologies, specialist physicians, and higher-quality care not available at other centers.1-2 The state of Maryland has already begun planning for regionalized care for patients with ACS.3 Recent enthusiasm for this movement has focused on its potential benefits. In this article, we present concerns about the rationale for regionalized ACS care and outline some potential unintended consequences.
Reported Benefits of ACS Centers
Recent articles arguing for the implementation of ACS care regionalization have discussed 3 principal benefits.1-2
Transfer for Primary Percutaneous Coronary Intervention Is More Effective Than Onsite Management With Fibrinolytic Therapy. Five randomized trials provide evidence for transferring patients with ST-elevation . . . [Full Text of this Article]
Author Affiliations: Section of Cardiovascular Medicine (Mr Rathore and Dr Krumholz), Robert Wood Johnson Clinical Scholars Program (Dr Krumholz), Department of Internal Medicine and Section of Health Policy and Administration, Department of Epidemiology and Public Health (Drs Epstein and Krumholz), Yale University School of Medicine and Center for Outcomes Research and Evaluation, Yale-New Haven Hospital (Dr Krumholz), New Haven, Conn; Department of Medicine, School of Medicine, University of Pennsylvania, Philadelphia (Dr Volpp); and the Veterans Affairs Center for Health Equity Research and Promotion, Philadelphia, Pa (Dr Volpp).
RELATED LETTERS
Acute Coronary Syndromes and Regionalization of Care
Bruce E. Haynes
JAMA. 2005;294(3):304.
EXTRACT
| FULL TEXT
Acute Coronary Syndromes and Regionalization of Care—Reply
Saif S. Rathore, Andrew J. Epstein, Kevin G. M. Volpp, and Harlan M. Krumholz
JAMA. 2005;294(3):304-305.
EXTRACT
| FULL TEXT
RELATED ARTICLE
Long-term Outcomes of Regional Variations in Intensity of Invasive vs Medical Management of Medicare Patients With Acute Myocardial Infarction
Therese A. Stukel, F. Lee Lucas, and David E. Wennberg
JAMA. 2005;293(11):1329-1337.
ABSTRACT
| FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Clinical impact of an inter-hospital transfer strategy in patients with ST-elevation myocardial infarction undergoing primary angioplasty: the Emilia-Romagna ST-segment elevation acute myocardial infarction network
Manari et al.
Eur Heart J 2008;29:1834-1842.
ABSTRACT
| FULL TEXT
Designing a Model Health Care System
Volpp
Am. J. Public Health 2007;97:2126-2128.
FULL TEXT
A Regional System to Provide Timely Access to Percutaneous Coronary Intervention for ST-Elevation Myocardial Infarction
Henry et al.
Circulation 2007;116:721-728.
ABSTRACT
| FULL TEXT
Development of Systems of Care for ST-Elevation Myocardial Infarction Patients: Gaps, Barriers, and Implications
Nallamothu et al.
Circulation 2007;116:e68-e72.
FULL TEXT
Percutaneous Coronary Intervention vs Thrombolysis for ST-Elevation Myocardial Infarction
Yan et al.
JAMA 2007;297:1313-1314.
FULL TEXT
Regionalization of ST-Segment Elevation Acute Coronary Syndromes Care: Putting a National Policy in Proper Perspective
Rathore et al.
J Am Coll Cardiol 2006;47:1346-1349.
ABSTRACT
| FULL TEXT
ST-Segment Elevation Myocardial Infarction: Recommendations on Triage of Patients to Heart Attack Centers: Is it Time for a National Policy for the Treatment of ST-Segment Elevation Myocardial Infarction?
Henry et al.
J Am Coll Cardiol 2006;47:1339-1345.
ABSTRACT
| FULL TEXT
Regionalized Care for Patients With ST-Elevation Myocardial Infarction: It's Closer Than You Think
Jacobs
Circulation 2006;113:1159-1161.
FULL TEXT
Driving Times and Distances to Hospitals With Percutaneous Coronary Intervention in the United States: Implications for Prehospital Triage of Patients With ST-Elevation Myocardial Infarction
Nallamothu et al.
Circulation 2006;113:1189-1195.
ABSTRACT
| FULL TEXT
Pre-Hospital 12-Lead Electrocardiography Programs: A Call for Implementation by Emergency Medical Services Systems Providing Advanced Life Support--National Heart Attack Alert Program (NHAAP) Coordinating Committee; National Heart, Lung, and Blood Institute (NHLBI); National Institutes of Health
Garvey et al.
J Am Coll Cardiol 2006;47:485-491.
ABSTRACT
| FULL TEXT
Racial Disparities in Cardiovascular Procedure Outcomes: Turn Down the Volume
Rumsfeld and Epstein
J Am Coll Cardiol 2006;47:425-426.
FULL TEXT
The Case for Community Hospital Angioplasty
Wharton et al.
Circulation 2005;112:3509-3534.
FULL TEXT
Acute Coronary Syndromes and Regionalization of Care
Haynes
JAMA 2005;294:304-304.
FULL TEXT
|
