Authors' objectives:

The guidelines are intended to provide guidance to health authorities on current and projected needs for cardiac surgery and interventional cardiology services, resource requirements for these services and organisational needs to ensure their efficient operation.

Authors' recommendations: Conclusions:Patterns of use of cardiac interventions are changing rapidly, but data to inform planning decisions and help predict future trends remains limited. Data needed includes risk-adjusted outcomes data, waiting list information and information about factors affecting access to services. Changes in indications could have a substantial impact on caseloads to the year 2001. In particular, the widespread use of coronary angioplasty in the treatment of evolving myocardial infarction could result in much higher caseloads. Health planners should aim for a relatively small number of larger cardiac surgery units rather than a proliferation of small units, taking into account distribution, access and cost of services, and quality of care concerns. Recommendations:Recommendations have been made in minimum caseloads for adult and paediatric cardiac surgery, interventional cardiology and electrophysiology units, and on minimum caseloads for surgeons and cardiologists performing each type of interventional cardiac procedure. Other recommendations include:Cardiac intervention services have specific requirements in terms of staff, beds, equipment and supporting services. Adequate provision of these requirements is necessary if patient safety and outcomes are not to be compromised. Laser assisted coronary angioplasty should only be used in the context of a clinical trial, until good evidence of cost effectiveness emerges. Cardiology units should ensure that, in an emergency, coronary angioplasty patients can be transferred to a fully-staffed cardiac surgery operating theatre within 30 minutes. Radiofrequency catheter ablation should only be performed by electrophysiologists. Other output or dissemination activity: Accepted by the Australian Health Ministers' Advisory Council

Authors' methods: Review

Project Status: Completed

URL for project: http://www.msac.gov.au/

Year Published: 1995

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Australia

Organisation Name: Australian Health Technology Advisory Committee

Contact Address: Naarilla Hirsch, Australian Institute of Health and Welfare Health Technology Unit, GPO Box 570, Canberra, ACT, 2601, Australia

Copyright: Australian Health Technology Advisory Committee