Impact of regionalisation of cardiac surgery in Emilia-Romagna, Italy
Journal of Epidemiology & Community HealthPublished 17 January 2004Open access
Lucia Nobilio
Citations18
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
Abstract
This study provides additional evidence on the benefit of regionalisation of cardiac surgery interventions. The system allowed each centre to reach the minimum caseload required to assure good quality of care. These findings suggest that policies aimed at increasing cooperation rather than competition among health service providers have a positive impact on quality of care. Timely referrals for surgery increased by 21% (95%CI: 1.12 to 1.31), and mean waiting times were reduced by 7.5 average days (95%CI: -10.33 to -4.71).
Keywords
MedicineEconomics, Econometrics and FinanceHealth Professions
Journal of Chronic DiseasesA new method of classifying prognostic comorbidity in longitudinal studies: Development and validation
49,938 Citations1987Mary E. Charlson, Peter Pompei +2 more
The method of classifying comorbidity provides a simple, readily applicable and valid method of estimating risk of death fromComorbid disease for use in longitudinal studies and further work in larger populations is still required to refine the approach.
New England Journal of MedicineHospital Volume and Surgical Mortality in the United States
4,978 Citations2002John D. Birkmeyer, Andrea E. Siewers +6 more
Mortality decreased as volume increased for all 14 types of procedures, but the relative importance of volume varied markedly according to the type of procedure.
European Journal of Cardio-Thoracic SurgeryEuropean system for cardiac operative risk evaluation (EuroSCORE)
3,376 Citations1999Samer A.M. Nashef, F. Roques +4 more
EuroSCORE is a simple, objective and up-to-date system for assessing heart surgery, soundly based on one of the largest, most complete and accurate databases in European cardiac surgical history and is recommend its widespread use.
New England Journal of MedicineShould Operations Be Regionalized?
1,768 Citations1979Harold S. Luft, John P. Bunker +1 more
This study examines mortality rates for 12 surgical procedures of varying complexity in 1498 hospitals to determine whether there is a relation between a hospital's surgical volume and its mortality rates.
Annals of Internal MedicineIs Volume Related to Outcome in Health Care? A Systematic Review and Methodologic Critique of the Literature
1,680 Citations2002Ethan A. Halm, Clara Lee +1 more
A systematic review of the research evidence linking volume and outcome in health care is conducted, to summarize and describe the methodologic rigor of the existing literature, and to highlight the research and policy implications of these findings.
BMJWhy we need observational studies to evaluate the effectiveness of health care
1,602 Citations1996Nicholas Black
The view is widely held that experimental methods (randomised controlled trials) are the "gold standard" for evaluation and that observational methods have little or no value, but this ignores the limitations of randomised trials.
PubMedSelective referral to high-volume hospitals: estimating potentially avoidable deaths.
775 Citations2000R. Adams Dudley, Kirsten L. Johansen +3 more
Initiatives to facilitate referral of patients to HVHs have the potential to reduce overall hospital mortality in California for the conditions identified and to determine the extent to which selective referral is feasible and to examine the potential consequences.
JAMAThe Decline in Coronary Artery Bypass Graft Surgery Mortality in New York State
334 Citations1995Edward L. Hannan
The overall decline in risk-adjusted mortality could not be explained by shifts in patients away from low-Volume surgeons to high-volume surgeons, and the performance of surgeons who were not consistently low- volume surgeons was markedly better, including the markedly better performance of surgeon who were new to the system.
JAMARegionalization of cardiac surgery in the United States and Canada. Geographic access, choice, and outcomes
166 Citations1995K. Grumbach
JAMARegionalization of Cardiac Surgery in the United States and Canada
161 Citations1995Kevin Grumbach
JAMAMortality in Medicare Beneficiaries Following Coronary Artery Bypass Graft Surgery in States With and Without Certificate of Need Regulation
117 Citations2002Mary Vaughan‐Sarrazin
New England Journal of MedicineRegionalization and the Underuse of Angiography in the Veterans Affairs Health Care System as Compared with a Fee-for-Service System
103 Citations2003Laura A. Petersen, Sharon‐Lise T. Normand +2 more
There is underuse of needed angiography after acute myocardial infarction in both the VA and Medicare systems, but the rate of underuse is significantly higher in the VA, and differences appear to be associated with limited on-site availability of cardiac procedures in the regionalized VA health care system.
CirculationCoronary Artery Bypass Mortality Rates in Ontario
69 Citations1996Jack V. Tu, C. David Naylor
The overall mortality rate was 3.01%, and the risk-adjusted mortality rate declined from 3.17% in 1991 to 2.93% in 1993, which is well within the expected range during the time period.
PubMedRegionalization of cardiac surgery in the United States and Canada. Geographic access, choice, and outcomes.
58 Citations1995Kevin Grumbach, George Anderson +3 more
BMJ Quality & SafetyVolume of clinical activity in hospitals and healthcare outcomes, costs, and patient access.
45 Citations1997Amanda Sowden, Vassilis Aletras +7 more
The results of systematic reviews carried out at the University of York are summarised to assess research into the possible relation between volume of clinical activity in hospitals and the outcomes of quality of health care, hospital costs, and patient access.
Medical CareEffects of an Expanding Home Care Program for the Terminally III
38 Citations1987Jane McCusker, Anne M. Stoddard
As the home care program expanded to provide more intensive home-hospice services, a trend was observed of greater cost savings among home-care users than among nonusers, and home- Care users showed significantly less variability in costs than nonusers.
Health PolicySelective referrals in a ‘hub and spoke’ institutional setting: the case of coronary angioplasty procedures
26 Citations2002Lucia Nobilio, Cristina Ugolini
This analysis of the highly-regulated cardiovascular sector of the health service in the Italian region of Emilia Romagna focuses on coronary angioplasty procedures (PTCA) and examines relations among centres before and after the official introduction of this hierarchical system completed the regionalisation of cardiovascular services.
