Access to cardiac sur ger y centers for cardiac and non-cardiac hospitalizations in adolescents and adults with congenital heart defects- a descriptive case series study

Tabassum Z., Insaf and Kristin M, Sommerhalter and Treeva A., Jaff, and Sherry L., Farr and Karrie F., Downing, and Ali N., Zaidi and George K., Lui, and Alissa R., Van Zutphen (2020) Access to cardiac sur ger y centers for cardiac and non-cardiac hospitalizations in adolescents and adults with congenital heart defects- a descriptive case series study. American Heart Journal, 236. pp. 1-15. ISSN 0002-8703

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Abstract

Background Individuals with congenital heart defects (CHDs) are recommended to receive all inpatient cardiac and noncardiac care at facilities that can offer specialized care. We describe geographic accessibility to such centers in New York State and determine several factors associated with receiving care there. Methods We used inpatient hospitalization data from the Statewide Planning and Research Cooperative System (SPARCS) in New York State 2008-2013. In the absence of specific adult CHD care center designations during our study period, we identified pediatric/adult and adult-only cardiac surgery centers through the Cardiac Surgery Reporting System to estimate age-based specialized care. We calculated one-way drive and public transit time (in minutes) from residential address to centers using R gmapsdistance package and the Google Maps Distance Application Programming Interface (API). We calculated prevalence ratios using modified Poisson regression with model-based standard errors, fit with generalized estimating equations clustered at the hospital level and subclustered at the individual level. Results Individuals with CHDs were more likely to seek care at pediatric/adult or adult-only cardiac surgery centers if they had severe CHDs, private health insurance, higher severity of illness at encounter, a surgical procedure, cardiac encounter, and shorter drive time. These findings can be used to increase care receipt (especially for noncardiac care) at pediatric/adult or adult-only cardiac surgery centers, identify areas with limited access, and reduce disparities in access to specialized care among this high-risk population. (Am Heart J 2021;236:22–36.)

Item Type: Article
Subjects: Medicine > KMC Mangalore > Cardiology
Medicine > KMC Mangalore > Cardiovascular & Thoracic Surgery
Depositing User: KMC LIB
Date Deposited: 20 Apr 2021 11:15
Last Modified: 20 Apr 2021 11:15
URI: http://eprints.manipal.edu/id/eprint/156617

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