A Theoretical Model for Delivery of Congenital Heart Surgery in the United States.
A Theoretical Model for Delivery of Congenital Heart Surgery in the United States.
复制标题
美国先天性心脏病手术的理论模型。
DOI：
10.1016/j.athoracsur.2020.06.057
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
T. Karamlou
中科院分区：
文献类型：
--
作者：
K. Welke;S. Pasquali;Paul Lin;C. Backer;D. Overman;Jennifer C. Romano;T. Karamlou
在美国有150多家医院开展先天性心脏手术（CHS）。许多医院相距很近，病人的平均出行距离为38.5英里。我们从一个理论上的空白开始，使用以人口密度和体积阈值为指导的客观方法来估计在美国提供CHS的医院的最佳数量和位置。方法根据已公布的数据，我们估计美国每年的CHS手术数量为3.25万例。我们根据人口密度对患者进行地理分布。大都市统计区（人口中心和具有密切经济/社会联系的周边地区）被用作潜在的医院地点。患者被分配到最近的医院，使所有医院的CHS手术量≥300例。结果我们估计有57家医院可以为美国周边地区服务。区域化后的理论医院容量中位数为451例（四分位数范围为366-648例）。患者出行距离的中位数为35.1英里。一些患者（6396/ 31895，占20%）旅行超过100英里。结论：sour模型表明，美国可以在现有基础上减少约100家CHS医院。随着医院的优化布局，患者的旅行负担将会减轻。该模型可作为通过CHS区域化改善护理服务的平台。
BackgroundOver 150 hospitals perform congenital heart surgery (CHS) in the United States. Many hospitals are close together, with a median patient travel distance of 38.5 miles. We began with a theoretical blank slate and used objective methodology guided by population density and volume thresholds to estimate the optimal number and locations of hospitals to provide CHS in the United States.MethodsGuided by published data, we estimated the number of CHS operations in the United States in to be 32,500 per year. We distributed patients geographically based on population density. Metropolitan Statistical Areas (population centers and surrounding areas with close economic/social ties) were used as potential hospital locations. Patients were assigned to the closest hospital location such that all hospitals had a CHS volume of ≥300 operations.ResultsWe estimated 57 hospitals could serve the contiguous United States. Median theoretical hospital volume after regionalization was 451 operations (interquartile range, 366-648). Median patient travel distance was 35.1 miles. Some patients (6396/31,895, 20%) traveled more than 100 miles.ConclusionsOur model suggests the United States could be served by approximately 100 fewer CHS hospitals than currently exist. With hospitals optimally placed, patient travel burden would decrease. This model serves as a platform to improve care delivery by regionalization of CHS.
接受诺伍德手术的患者的中心体积和结果之间的复杂关系。
DOI：
10.1016/j.athoracsur.2011.07.081
发表时间：
2012
期刊：
The Annals of thoracic surgery
影响因子：
--
作者：
Pasquali,SaraK;Jacobs,JeffreyP;He,Xia;Hornik,ChristophP;Jaquiss,RobertDB;Jacobs,MarshallL;O'Brien,SeanM;Peterson,EricD;Li,JenniferS
通讯作者：
Li,JenniferS