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The many advances in cardiovascular diagnostic imaging technology, interventional procedures, drug development and elucidation of risk factors have resulted in a steady reduction in deaths from cardiovascular disease in most European countries. However CVD still remains the leading cause of mortality in Europe, with an annual toll of 4.3 million deaths, and experts predict that, with the ageing population as well as lifestyle changes that are increasing the prevalence of obesity and Type 2 diabetes, we are now facing a CVD epidemic that could overwhelm our health services.
Because of effective dissemination of information on CVD, people are increasingly aware of the modifiable risk factors, which include tobacco use and excessive alcohol consumption, a paucity of suitable exercise and a high fat and sugar diet. Many patients also know that statins, which reduce Low-Density Lipoprotein Cholesterol levels, can be taken for primary prevention of CVD; some even expect these drugs on demand. Indeed over 10% of UK residents now take statins, and The National Institute for Health and Care Excellence (NICE) is currently updating its guidelines to recommend statin therapy if the assessed risk of developing CVD within 10 years is 10% (the previous guidelines stated 20%). The American Heart Association and American College of Cardiology
The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a patient survey that provides structured inputs to monitor and assess hospital services, and drive their improvement. HCAHPS (pronounced
Interventional cardiology, like minimally invasive surgery, has for decades been driven by miniaturization. New lightweight, biocompatible and sometimes self-expanding materials (for catheters and stents), alongside sophisticated digital imaging algorithms, have been the key technology enablers. These, in turn, have reduced vascular complications and hemostasis as well as the use of contrast agents
The emergence of transradial access
One recent development is transradial access, where a catheter is introduced through the radial rather than femoral artery. Making this feasible has been the arrival of automated contrast injectors which permit improvements in angiographic image resolution.
Typically, smaller catheters in use today are 5 Fr. Sheathless catheters promise to reduce the miniaturization envelope even further, since the catheter sheath typically adds 1-2 Fr in diameter. In such circumstances, some foresee a future with what are effectively equivalent to 3 Fr interventions based on a 4 or 5 Fr sheathless catheter.
Cardiologists divided over smaller catheters
However, there is still doubt about the impact of smaller catheters on procedural efficiency and outcomes. In turn, this dovetails into a longer-running debate about the utility of radial access (one of the drivers of demand for smaller catheters) versus the femoral route.
Interventional cardiologists seem divided into two camps on the issue.
The first consists of those who believe 6 Fr (considered
Transcatheter aortic valve implantation (TAVI) is the use of catheterized access via a blood vessel to replace the heart
Escalating costs make new business model unavoidable
There is still no consensus about where hospitals should be positioned in the healthcare service spectrum of the future. However, it is widely accepted that relying wholly on growth in patient numbers, bed-days and on more expensive equipment, procedures and physicians has become untenable.
Some hospitals are enthusiastically embracing change. Many more remain cautious. Few however doubt that spiralling healthcare costs will force hospitals to be funded and operated via new business models, more akin to that of other economic sectors.
All things to all people, all the time
Innosight, a healthcare consultancy founded by Harvard Business School Professor Clay Christensen, puts the problem in perspective. In marked contrast to general hospitals, few organizations
In Austria, as elsewhere, integrated healthcare plays a major role in the national healthcare strategy as laid down in the Austrian Healthcare
Structure Plan. Long before the ELGA national EHR* scheme, two large hospital operators pioneered in exchanging patient data across institutions and regions.
Exchanging medical data electronically between healthcare providers is indispensable for patient-centric treatment across specialties and facility borders. In Austria, the implementation of a nation-wide electronic health record called ELGA is finally in full swing. By 2017, hospitals, physicians, care facilities and pharmacies are expected to meet the technical prerequisites for participation in ELGA. But the two largest private, non-profit hospital operators in Austria, the religious order hospital groups Barmherzige Br
April 2024
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Beukenlaan 137
5616 VD Eindhoven
The Netherlands
+31 85064 55 82
info@interhospi.com
PanGlobal Media IS not responsible for any error or omission that might occur in the electronic display of product or company data.
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