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

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 receiv...

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Autores principales: Insaf, Tabassum Z., Sommerhalter, Kristin M., Jaff, Treeva A., Farr, Sherry L., Downing, Karrie F., Zaidi, Ali N., Lui, George K., Van Zutphen, Alissa R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8097661/
https://www.ncbi.nlm.nih.gov/pubmed/33636136
http://dx.doi.org/10.1016/j.ahj.2021.02.018
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author Insaf, Tabassum Z.
Sommerhalter, Kristin M.
Jaff, Treeva A.
Farr, Sherry L.
Downing, Karrie F.
Zaidi, Ali N.
Lui, George K.
Van Zutphen, Alissa R.
author_facet Insaf, Tabassum Z.
Sommerhalter, Kristin M.
Jaff, Treeva A.
Farr, Sherry L.
Downing, Karrie F.
Zaidi, Ali N.
Lui, George K.
Van Zutphen, Alissa R.
author_sort Insaf, Tabassum Z.
collection PubMed
description 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.
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spelling pubmed-80976612022-06-01 Access to cardiac surgery centers for cardiac and non-cardiac hospitalizations in adolescents and adults with congenital heart defects- a descriptive case series study Insaf, Tabassum Z. Sommerhalter, Kristin M. Jaff, Treeva A. Farr, Sherry L. Downing, Karrie F. Zaidi, Ali N. Lui, George K. Van Zutphen, Alissa R. Am Heart J Article 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. 2021-02-23 2021-06 /pmc/articles/PMC8097661/ /pubmed/33636136 http://dx.doi.org/10.1016/j.ahj.2021.02.018 Text en https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) )
spellingShingle Article
Insaf, Tabassum Z.
Sommerhalter, Kristin M.
Jaff, Treeva A.
Farr, Sherry L.
Downing, Karrie F.
Zaidi, Ali N.
Lui, George K.
Van Zutphen, Alissa R.
Access to cardiac surgery centers for cardiac and non-cardiac hospitalizations in adolescents and adults with congenital heart defects- a descriptive case series study
title Access to cardiac surgery centers for cardiac and non-cardiac hospitalizations in adolescents and adults with congenital heart defects- a descriptive case series study
title_full Access to cardiac surgery centers for cardiac and non-cardiac hospitalizations in adolescents and adults with congenital heart defects- a descriptive case series study
title_fullStr Access to cardiac surgery centers for cardiac and non-cardiac hospitalizations in adolescents and adults with congenital heart defects- a descriptive case series study
title_full_unstemmed Access to cardiac surgery centers for cardiac and non-cardiac hospitalizations in adolescents and adults with congenital heart defects- a descriptive case series study
title_short Access to cardiac surgery centers for cardiac and non-cardiac hospitalizations in adolescents and adults with congenital heart defects- a descriptive case series study
title_sort access to cardiac surgery centers for cardiac and non-cardiac hospitalizations in adolescents and adults with congenital heart defects- a descriptive case series study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8097661/
https://www.ncbi.nlm.nih.gov/pubmed/33636136
http://dx.doi.org/10.1016/j.ahj.2021.02.018
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