28 Jan Keeping Cardiac Catheterization Labs Open On Weekends May Save Money
MedicalResearch.com Interview with:
Andre Lamy MD MHSc
COMPASS (CABG sub-group PI) CORONARY Principal Investigator
Professor, Dept Surgery, Division Cardiac Surgery
Associate Member, Dept Clinical Epidemiology & Biostatistics
McMaster University Hamilton General Hospital
Hamilton, ON, Canada
Medical Research: What is the background for this study?
Dr. Lamy: The Canadian healthcare system operates in an environment that must constantly find new ways to make healthcare delivery more efficient. In the TIMACS clinical led by Dr. Shamir Mehta, it was found that the primary outcome was similar for an early invasive procedure within 24 hours and a delayed approach of after 36 hours in outcomes. However, because of the inherent shorter length of stay associated with early invasive procedures within 24 hours there will be definite cost-savings from an early invasive strategy. Dr. Andre Lamy et al looked at the cost implications of this shorter length of stay in the TIMACS trial and explored the impact of the use of a catheterization lab on days when they are normally not in use (i.e. weekends), which may negate the savings of early intervention.
Medical Research: What are the main findings?
Dr. Lamy: The main findings of our study were that early invasive strategy was cost-saving for Canadian NTSE-ACS patients due to significant savings from the shorter length of stay. These savings were present even if as many as 50% of TIMACS patients were assumed to be weekend cases. Given many high-risk NSTE-ACS patients receive delayed intervention due to weekend catheterization lab status, these findings support operating catheterization labs on weekends to facilitate the use of early invasive intervention.
Medical Research: What should clinicians and patients take away from your report?
Dr. Lamy: For decision makers, early intervention will save money even if this requires operating the catheterization lab on weekends for some cases. For patients, although the primary outcome of the TIMACS trial was similar for both treatment groups in the overall TIMACS population, it was superior in those patients who were at a higher risk of ischemic events. In addition the composite secondary outcome of death, myocardial infarction or refractory ischemia was reduced in the overall study population. This should translate to a better quality of life for patients.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Lamy: Our analysis on the feasibility of catheterization labs operation on weekends was conducted as a sensitivity analysis. More input on the acceptability of this concept by not only healthcare staff, but also patients is required. It implies that a patient could be treated by a team of doctors seven days a week rather than a single dedicated doctor who is off for the weekend. Running our catheterization labs all week is likely more cost efficient but may not be acceptable to all involved.
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Last Updated on January 28, 2015 by Marie Benz MD FAAD