Medical Research: What is the background for this study? What are the main findings?
Dr. Hassan: For years, geographic place of residence and one’s proximity to a tertiary care center has been identified as a predictor for access to care. Little is known regarding the effect of geography on patient outcomes. The purpose of this study was to explore the relationship between geography and in-hospital / 30-day outcomes among patients undergoing cardiac surgery. What we found was that despite there being no relationship between geography and in-hospital outcomes, those who lived further away from hospital clearly had worse 30-day outcomes.
Medical Research: What should clinicians and patients take away from your report?
Dr. Hassan: While patients from a differing geographic places of residence appear to have similar in-hospital outcomes following cardiac surgery, their clinical courses following discharge from hospital differ considerably. Clinicians and patients need to realize that where one lives is tremendously important as it relates to his or her health and that particular attention needs to be paid to cardiac surgery patients who live further away from their tertiary care center, especially within the first 30 days following surgery.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Hassan: This is a study that will hopefully generate a lot of conversation around the subject of 30-day outcomes following cardiac surgery. However, before we instinctively jump to trying to solve the geographic discrepancies found in this study, we need to know more about why these differences existed in the first place. Was it that patients from further away experienced more complications following surgery? Was it that they had impaired access to local health care facilities and that it was this decrease in access that led to worse outcomes? Was it that they were more likely to be readmitted to their local hospital with complications and or clinical presentations that would have been managed as an outpatient had they been seen at the hospital where their surgery was performed? These questions need to be answered before we can jump to the desired step of proposing solutions.
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MedicalResearch.com Interview with: Dr. Ansar Hassan MD PhD (2015). Distance From Hospital Linked To Worse 30-Day Cardiac Surgery Outcomes